EFFECT OF NUCHAL CORD ON PERINATAL OUTCOMES

Yıl 2016, Cilt: 49 Sayı: 1, 36 - 39, 01.03.2016

Burak Karadağ Tufan Arslanca Ceyda Etleç Banu Arslanca Yetkin Karasu Hatice Tatar Aksoy Yusuf Ergun

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

• )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.
• )Collins JH, Collins CL, Weckwerth SR, De Angelis L. Nuchal cords: timing of prenatal diagnosis and duration.Am J Obstet Gynecol. 1995; 173: 768.
• )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.
• )Shrestha NS, Singh N. Nuchal cord and perinatal outcome. Kathmandu Univ Med J (KUMJ). 2007; 5: 360–363.
• )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.
• )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.
• )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.
• )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.
• )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.
• )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.
• )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.
• )Narang Y, Vaid NB, Jain S et al. Is nuchal cord justified as a cause of obstetrician anxiety? Arch Gynecol Obstet. 2014; 289: –801.
• )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.