Maternal and neonatal outcome in newborns with nuchal cord loop: a comparative study

Background: To compare the maternal and neonatal outcome between the new-born with and without nuchal cord loop at the time of delivery.Methods: It is a prospective comparative study, conducted in Mahatma Gandhi Medical College and Research Institute, Pondicherry from August 2013 to May 2014. All the pregnant women, who fulfill the inclusion and exclusion criteria, were taken into account and allowed to have the normal course of labour. At the time of delivery all neonates born with nuchal cord loop were taken as the study group and without nuchal cord loop were included in the control group. Cord blood gas analysis was done using blood gas analyzer (Radiometer ABL5) for neonates with Apgar score <7 at 1 minutes. Outcomes measured were requirement of induction of labour, requirement of augmentation with oxytocin following spontaneous onset of labour, duration of labour, mode of delivery , amniotic fluid index, foetal heart rate irregularities, birth weight, meconium stained liquor, Apgar score, cord blood gas analysis like pH, PO2, PCO2 (neonatal parameters) in new-born with nuchal cord loop.Results: There were no statistically significant differences between the two groups in relation to  maternal outcome .As far as neonatal outcome concerned, although meconium stained liquor (15.3% vs. 10.6% ), foetal heart irregularities (20.9% vs. 11.5 %) and 1st minutes Apgar score <7 (13.2% vs. 7.2%, p=0.033)  are more  in the study group , the   difference is not significant.Conclusions: The study concluded that the presence of nuchal cord loop does not adversely affect the maternal outcome. Although it increases the meconium stained liquor, affect FHR irregularities and low 1st minute Apgar score, it does not increase the operative interference in mother.