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Risk factors of clinical birth asphyxia and subsequent newborn death following nuchal cord in a low-resource setting

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DOI: 10.4236/ojog.2013.39117    4,357 Downloads   5,836 Views   Citations

ABSTRACT

Introduction: Our aim was to identify the risk factors of clinical birth asphyxia and subsequent newborn death in the presence of nuchal cord in a sub-Saharan Africa setting. Methodology: It was a six-months’ case-control study involving 117 parturients whose babies presented with a nuchal cord at delivery. The study was carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon, from January 1st to June 30th 2013. Results: The risk factors of clinical birth asphyxia identified were: first delivery, absence of obstetrical ultrasound during pregnancy, nuchal cord with more than one loop, duration of second stage of labor more than 30 minutes during vaginal delivery. The risk factors for newborn death from clinical birth asphyxia in the presence of nuchal cord were: maternal age < 20 years, first delivery, absence of obstetrical ultrasound during pregnancy, nuchal cord with more than one loop, tight nuchal cord, duration of second stage of labor more than 30 minutes during vaginal delivery. Conclusion: We recommend a systematic obstetrical ultrasound before labor, so as to detect the presence of a nuchal cord, its tightness and the number of loops. Also, cesarean section should be considered when a nuchal cord is associated with first delivery, tightness or multiple looping.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Foumane, P. , Nkomom, G. , Mboudou, E. , Sama, J. , Nguefack, S. and Moifo, B. (2013) Risk factors of clinical birth asphyxia and subsequent newborn death following nuchal cord in a low-resource setting. Open Journal of Obstetrics and Gynecology, 3, 642-647. doi: 10.4236/ojog.2013.39117.

References

[1] Dhar, K.K., Ray, S.N. and Dhall, G.I. (1995) Significance of nuchal cord. Journal of the Indian Medical Association, 93, 451-453.
[2] Schaffer, L., Burkhardt, T., Zimmermann, R. and Kurmanavicius, J. (2005) Nuchal cords in term and postterm deliveries—Do we need to know? Obstetrics & Gynecology, 106, 23-28. http://dx.doi.org/ 10.1097/01.AOG.0000165322.42051.0f
[3] Nkwabong, E. and Fomulu, J.N. (2011) Neonatal outcome in cases of nuchal cord in Cameroon. International Journal of Gynecology & Obstetrics, 114, 287-288. http://dx.doi.org/10.1016/j.ijgo. 2011.03.022
[4] Kemfang Ngowa, J.D., Kasia, J.M., Nsangou, I., Zedjom, C., Domkam, I., Morfaw, F., et al. (2011) Nuchal cord and perinatal outcome at the Yaounde General Hospital, Cameoon. Clinics in Mother and Child Health, 8, C101201. http://dx.doi.org/10.4303/cmch/C101201
[5] Sheiner, E., Abramowicz, J.S., Levy, A., Silberstein, T., Mazor, M. and Hershkovitz, R. (2006) Nuchal cord is not associated with adverse perinatal outcome. Archives of Gynecology and Obstetrics, 274, 81-83. http://dx.doi.org/10.1007/s00404-005-0110-2
[6] Shrestha, N.S. and Singh, N. (2007) Nuchal cord and perinatal outcome. Kathmandu University Medical Journal (KUMJ), 5, 360-363.
[7] Ghosh, G.S. and Gudmundsson, S. (2008) Nuchal cord in post-term pregnancy-relationship to suspected intrapartum fetal distress indicating operative intervention. Journal of Perinatal Medicine, 36, 142-144. http://dx.doi.org/10.1515/JPM.2008.012
[8] Larson, J.D., Rayburn, W.F., Crosby, S. and Thurnau, G.R. (1995) Multiple nuchal cord entanglements and intrapartum complications. American Journal of Obstetrics & Gynecology, 173, 1228-1231. http://dx.doi.org/10.1016/0002-9378(95)91359-9
[9] Assimakopoulos, E., Zafrakas, M., Garmiris, P., Goulis, D.G., Athanasiadis, A.P., Dragoumis, K. and Bontis, J. (2005) Nuchal cord detected by ultrasound at term is associated with mode of delivery and perinatal outcome. European Journal of Obstetrics & Gynecology and Reproductive Biology, 123, 188-192. http://dx.doi.org/10.1016/j.ejogrb.2005.02.026
[10] Rhoades, D.A., Latza, U. and Mueller, B.A. (1999) Risk factors and outcomes associated with nuchal cord. A population-based study. Journal of Reproductive Medicine, 44, 39-45.
[11] Ghi, T., D’Emidio, L., Morandi, R., Casadio, P., Pilu, G. and Pelusi, G. (2007) Nuchal cord entanglement and outcome of labour induction. Journal of Reproductive Medicine, 1, 57-60.
[12] Ogueh, O., Al-Tarkait, A., Vallerand, D., Rouah, F., Morin, L., Benjamin, A., et al. (2006) Obstetrical factors related to nuchal cord. Acta Obstetricia et Gynecologica Scandinavica, 85, 810-814. http://dx.doi.org/10.1080/00016340500345428
[13] Salvador, J., Cunillé, M., Lladonosa, A., Ricart, M., Cabré, A. and Borrell, C. (2001) Characteristics of pregnant women and routine antenatal care in Barcelona, 1994-1999. Gaceta Sanitaria, 15, 230-236. http://dx.doi.org/10.1016/S0213-9111(01)71552-X
[14] González-Quintero, V.H., Tolaymat, L., Muller, A.C., Izquierdo, L., O’Sullivan, M.J. and Martin, D. (2004) Outcomes of pregnancies with sonographically detected nuchal cords remote from delivery. Journal of Ultrasound in Medicine, 23, 43-47.
[15] Mastrobattista, J.M., Hollier, L.M., Yeomans, E.R., Ramin, S.M., Day, M.C., Sosa, A., et al. (2005) Effects of nuchal cord on birthweight and immediate neonatal outcomes. American Journal of Perinatology, 22, 83-85. http://dx.doi.org/10.1055/s-2005-837737
[16] Jauniaux, E., Ramsay, B., Peellaerts, C. and Scholler, Y. (1995) Perinatal features of pregnancies complicated by nuchal cord. American Journal of Perinatology, 12, 255-258. http://dx.doi.org/ 10.1055/s-2007-994467

  
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