<- Home <- Arhive <- Vol. 24, Issue 4, December 2016



Rom J Leg Med24(4)289-293(2016)
DOI:10.4323/rjlm.2016.289
© Romanian Society of Legal Medicine


Medico-legal issues of the nuchal cord at birth

L. Pleș, V. Beliș, A. Rîcu, R. M. Sima


Abstract: Introduction. The aim of this study was to identify the incidence of the nuchal cord at birth in our clinic, it's impact on the fetal and neonatal evolution in correlation with the adopted way of delivery and to debate the medico-legal associated issues related to this condition.
Material and methods. The study included the evaluation of 1996 women that delivered in Clinical Emergency Hospital “Saint John”, “Bucur” Maternity from January 1st, 2015 to December 31st, 2015. We studied the presence and type of the nuchal cord at delivery, the APGAR score, the correlation between APGAR score and nuchal cord identification and the antepartum ultrasound diagnosis of the nuchal cord.
Results. Our retrospective study included 819 patients. The delivery mode was: vaginal in 67.28% and by Caesarean section in 32.72% cases. The APGAR score less than 7 represented 0.5%. It was identified that cord pathology did not correlate well with the APGAR score. The children with APGAR score less than 7 were delivered in most of cases by Caesarian section (64.3%), but only 15.3% of the indication were for fetal distress. Ultrasound prenatal scan identified multiple nuchal cord loop in 34.7% cases and was confirmed in 93% cases after delivery.
Conclusion. Nuchal cord at birth is a frequent finding and the study shows that, in most case there is no association between its presence and poor neonatal outcome. The presence of nuchal cord at ultrasound scan in the third trimester or in the labour ward does not impose Caesarian section delivery.
Keywords: nuchal cord, antepartum diagnosis, medico-legal implication, APGAR score.

Material and methods. The study included the evaluation of 1996 women that delivered in Clinical Emergency Hospital “Saint John”, “Bucur” Maternity from January 1st, 2015 to December 31st, 2015. We studied the presence and type of the nuchal cord at delivery, the APGAR score, the correlation between APGAR score and nuchal cord identification and the antepartum ultrasound diagnosis of the nuchal cord.
Results. Our retrospective study included 819 patients. The delivery mode was: vaginal in 67.28% and by Caesarean section in 32.72% cases. The APGAR score less than 7 represented 0.5%. It was identified that cord pathology did not correlate well with the APGAR score. The children with APGAR score less than 7 were delivered in most of cases by Caesarian section (64.3%), but only 15.3% of the indication were for fetal distress. Ultrasound prenatal scan identified multiple nuchal cord loop in 34.7% cases and was confirmed in 93% cases after delivery.
Conclusion. Nuchal cord at birth is a frequent finding and the study shows that, in most case there is no association between its presence and poor neonatal outcome. The presence of nuchal cord at ultrasound scan in the third trimester or in the labour ward does not impose Caesarian section delivery.&redirect_uri=http://rjlm.ro/index.php/arhiv/513' class='share_fb'>


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