A rare case of six loops of nuchal cord

Abstract

Nuchal cord is defined as ≥360° wrapping of the umbilical cord around the fetal neck. Despite good prognosis in majority of cases, nuchal cord may be associated with variable fetal heart rate deceleration, decreased fetal movements, fetal distress& even intrauterine fetal demise. We present a primigravida woman, who delivered a healthy male baby with five loops of cord around neck. A 26 years old primigravida woman presented with 38 weeks of pregnancy. She had hydramnios, fibroid complicating pregnancy with breech presentation. At the time of delivery of the head it was observed that the baby had five loops of cords around the neck & there was no knot in the cord. Baby cried immediately after birth and had good tone & activity. Risk factors for a nuchal cord include Long umbilical cord length, baby being large for gestational age, Multiple gestation pregnancies, Nutritional deficiencies affecting the structure and protective barrier of the umbilical cord, hydramnios, Abnormal fetal presentation during delivery, such as breech or shoulder presentation. Sensitivity of ultrasound diagnosis of a nuchal cord prior to induction of labour at term is low around 37.5%. Colour doppler has a senstivity of 60% to 95% with a false positive rate of 19% in diagnosis.Our patient was monitored with regular biophysical profiles, non-stress tests & Doppler assessment of the umbilical artery hence delivered a healthy baby.