INCIDENCE AND EPIDEMIOLOGICAL CORRELATES OF NUCHAL CORD: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background: Nuchal cord, defined as the encirclement of the fetal neck by the umbilical cord, is a frequent obstetric finding with potential implications for perinatal outcomes. While many cases are benign, its association with adverse neonatal events has been a subject of clinical debate. This prospective study investigates the incidence of nuchal cord and its epidemiological correlates in a tertiary care setting in India.
Methods: A prospective, observational, and comparative study was conducted at Narayana Multispeciality Hospital, Jaipur, Rajasthan, from June 2019 to June 2020. The study enrolled 400 term pregnant women with singleton pregnancies in cephalic presentation and spontaneous labor onset, after obtaining informed consent and ethical committee approval. Exclusion criteria included antenatal complications, premature rupture of membranes, and post-dated pregnancies. Maternal demographics, obstetric history, and sonographic parameters were documented. The presence, number of loops, and tightness of nuchal cord were assessed at delivery. Standard intrapartum monitoring and neonatal assessments (APGAR scoring and NICU admissions) were performed. Data were statistically analyzed using MedCalc v16.4 with appropriate comparative tests.
Results: The study found an overall nuchal cord incidence of 21.25%. Among the 85 cases identified, the majority (64.71%) had a single loop, whereas multiple loops (2–4 loops) constituted the remainder. Analysis of loop tightness revealed that 45.88% were classified as tight cords. Maternal age distribution indicated that the highest frequency of nuchal cord occurred in the 25–29 years age group (58.82%). Although no significant adverse neonatal outcomes were directly attributable to nuchal cord in this cohort, there was a trend toward lower APGAR scores and increased NICU admissions in cases involving multiple or tight loops.
Conclusion: The incidence of nuchal cord in term pregnancies at our tertiary care center was comparable to previously reported rates. While most nuchal cords were single and loose, increased loop number and tightness may predispose to compromised neonatal outcomes, necessitating vigilant intrapartum monitoring. Future research should focus on stratified risk assessment to optimize perinatal management.