- Leonhard Schaffer, MD
Leonhard Schaffer, MD
- Associate Professor
- Head of Obstetrics
- Kantonsspital Baden AG
- Affiliated Hospital of the University of Zurich
- Roland Zimmermann, MD
Roland Zimmermann, MD
- Director & Professor
- Department Of Obstetrics
- University Hospital of Zurich, Switzerland
- Section Editors
- Lynn L Simpson, MD
Lynn L Simpson, MD
- Section Editor — Obstetrics
- Professor of Obstetrics and Gynecology
- Columbia University College of Physicians and Surgeons
- Deborah Levine, MD
Deborah Levine, MD
- Section Editor — Imaging
- Professor of Radiology
- Director of Ob/Gyn Ultrasound
- Department of Radiology
- Beth Israel Deaconess Medical Center
A loop of umbilical cord around the fetal neck (nuchal cord) is a common finding at delivery. In most cases, it is not associated with a significant increase in the rate of any clinically important adverse fetal/neonatal outcome. In case reports and small case series, tight nuchal cords have been associated with adverse outcomes, including fetal asphyxia and demise, but causality has not been proven. This topic will discuss issues related to prenatal diagnosis of nuchal cords, pregnancy and intrapartum management, and potential outcomes.
The term nuchal cord describes an umbilical cord that passes 360 degrees around the fetal neck. Nuchal cords can be classified as :
●Single or multiple
●Loose or tight (ie, compressing the fetal neck)
●Type A or B (figure 1)
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- PRENATAL DIAGNOSIS
- Diagnostic performance of ultrasound
- Differential diagnosis
- NATURAL HISTORY
- POSSIBLE SEQUELAE DURING PREGNANCY
- Fetal demise
- Impaired intrauterine growth
- Abnormalities in tests for fetal evaluation
- - First-trimester combined test for Down syndrome screening
- - Antepartum fetal monitoring
- - Intrapartum fetal monitoring
- PREGNANCY MANAGEMENT
- During labor
- NEONATAL OUTCOMES
- Neonatal intensive care unit admission
- Long-term neurodevelopmental abnormalities
- SUMMARY AND RECOMMENDATIONS