EFFECT OF NUCHAL CORD ON PERINATAL OUTCOMES

Öz

OBJECTIVE: To compare the perinatal outcomes of newborns with nuchal cord and newborns without nuchalcord.MATERIAL AND METHODS: This retrospective study included 100 newborns who borned in Ankara Teaching and Research Hospital between May 2015 and October 2015. There were 49 newborn without nuchal cord group 1 and 51 newborn with nuchal cord Group 2 . Demographic findings and perinatal outcomes were compared on patients’ files.RESULTS: Mean first minute Apgar scores in group 1 was 8 and in group 2 was 8 . Mean 5th minute Apgar score in group 1 was 9 and in group 2 was 9 p=0,002/p=0,001 respectively . Umblical cord pH was lower in group 2 Group 1: 7,3±0,05 and Group 2: 7,2±0,08 p=0,001 . There were 4 8,2% newborn in group 1 and 13 25% newborn in group 2 treated in intensive care unit p=0,021 .CONCLUSION: We found that nuchal cord presence may cause decreased Apgar scores at birth and increased need for intensive care unit treatment

Anahtar Kelimeler

• Nuchal cord,Umblical cord pH,Apgar score,Perinatal outcome

NUKAL KORDUN GEBELİK SONUÇLARINA ETKİSİ

Öz

AMAÇ: Nukal kord ile doğan bebeklerin perinatal sonuçlarını; nukal kord bulunmayan bebeklerle karşılaştırmak.GEREÇ VE YÖNTEMLER: Bu retrospektif çalışmaya 2015 mayıs-ekim tarihleri arasında Ankara Eğitim Araştırma Hastanesi’nde doğum yapan 100 hasta dahil edildi. Hastalar; grup 1 nukal kordu bulunmayan 49 hasta ve grup 2 nukal kordu bulunan 51 hasta olarak iki gruba ayrıldı. Grupların demografik özellikleri ve perinatal sonuçları hasta dosyaları incelenerek karşılaştırıldı.BULGULAR: Bebeklerin birinci dakika Apgar skorları grup 1‘de 8 ; grup 2’de 8 beşinci dakika Apgar skorları grup 1 ‘de 9 ; grup 2‘de 9 idi sırasıyla p=0,002/p=0,001 . Umblikal kord pH’sı grup 2’de daha düşüktü sırasıyla grup1’de 7,3±0,05, grup 2’ de 7,2±0,08 p=0,001 . Grup 1 ‘de 4 %8,2 , grup 2 ‘de 13 %25,5 bebeğin yoğun bakım gereksinimi olmuştu p=0,021 .SONUÇ: Çalışmamızda nukal kord varlığının; düşük Apgar skorları ve artmış yenidoğan yoğun bakım ihtiyacı ile ilişkili olduğunu ve sonuç perinatal sonuçları olumsuz etkilediğini gördük

Anahtar Kelimeler

• Nukal kord,Umblikal kord kan gazı,Apgar skoru,Perinatal sonuçlar

Kaynakça

1. )Clapp JF, Stepanchak W, Hashimoto K, Ehrenberg H, Lopez B. The natural history of antenatal nuchal cords.Am J Obstet Gyne- col. 2003; 189: 488–493.
2. )Collins JH, Collins CL, Weckwerth SR, De Angelis L. Nuchal cords: timing of prenatal diagnosis and duration.Am J Obstet Gynecol. 1995; 173: 768.
3. )Sheiner E, Abramowicz JS, Levy A, Silberstein T, Mazor M, Hershkovitz R. Nuchal cord is not associated with adverse peri- natal outcome. Arch Gynecol Obstet. 2006; 274: 81–83.
4. )Shrestha NS, Singh N. Nuchal cord and perinatal outcome. Kathmandu Univ Med J (KUMJ). 2007; 5: 360–363.
5. )Lal N, Deka D, Mittal S. Does the nuchal cord persist? Anul- trasound and color-Doppler-based prospective study. J Obstet Gynaecol Res. 2008; 34: 314–317.
6. )Schaffer L, Burkhardt T, Zimmermann R, Kurmanavicius J. Nuchal Cords in term and Postterm Deliveries- do we need to know? Obstet Gynecol. 2005; 106: 23–28.
7. )Spellacy WN, Gravem H, Fisch RO. The umbilical cord com- plications of true knots, nuchal coils, and cords around the body. Report from the collaborative study of cerebral palsy. Am J Ob- stet Gynecol. 1966; 94: 1136–1142.
8. )Hankins GD, Snyder RR, Hauth JC, Gilstrap LC 3rd, Ham- mond T. Nuchal cords and neonatal outcome. Obstet Gynecol. ; 70: 687–691. )Singh G, Sidhu K. Nuchal cord: a retrospective analysis. Med J Armed Forces India. 2008; 64: 237–240.

9. )Gonza´lez-Quintero VH, Tolaymat L, Muller AC, Izquierdo L, O’Sullivan MJ, Martin D. Outcomes of pregnancies with sono- graphically detected nuchal cords remote from delivery. J Ultra- sound Med. 2004; 23: 43–47.
10. )Peregrine E, O’Brien P, Jauniaux E. Ultrasound detection of nuchal cord prior to labor induction and the risk of Cesarean sec- tion. Ultrasound Obstet Gynecol. 2005; 25: 160–164.
11. )Onderoglu LS, Dursun P, Durukan T. Perinatal features and umbilical cord blood gases in newborns complicated with nuchal cord. Turkish J Pediatr. 2008; 50: 466–470.
12. )Narang Y, Vaid NB, Jain S et al. Is nuchal cord justified as a cause of obstetrician anxiety? Arch Gynecol Obstet. 2014; 289: –801.
13. )Hoh JK, Sung YM, Park MI. Fetal heart rate parameters and perinatal outcomes in fetuses with nuchal cords. J. Obstet. Gy- naecol. 2012; 38: 358–363.