The Comparative Study Umbilical Cord Blood Gases and Perinatal Outcome in Newborns with or without Nuchal Cord in Alzahra Hospital, 2018

Background: Entanglement of the umbilical cord around fetal neck is one of the causes of birth asphyxia. Umbilical cord blood gases can largely show embryonic metabolic status and asphyxia at birth. Studies report inconsistent results of the umbilical cord entanglement. Therefore, the present study we aimed to evaluate and compare the perinatal outcome and umbilical cord blood gases in two groups of neonates with and without nuchal cord in mothers referring to the delivery department of Alzahra Hospital in Rasht in 2018.Methods: This cohort study was performed on 168 pregnant women with term pregnancy referred to Alzahra hospital in Rasht in 2018. Two groups )with and without nuchal cord(,were compared in terms of maternal demographic characteristics, umbilical cord blood gases (PH, Po2, PCO2, HCO3 and Base excess), duration of active phase of labor until delivery, type of delivery, fetal weight and sex, the number of entanglement of the umbilical nuchal cord, the first and fifth minute APGAR, meconium excretion and NICU requirements. SPSS software (V:21) were used. Chi-square and Fisher exact test were used to compare the qualitative and quantitative data between the two groups, and T-test was used for quantitative variables with normal distribution. Mann Whitney test was used for non-normal distribution. were used. p<0.05 was taken as the significant level.Results: In this study, 84 pregnant women in each group with and without nuchal cord were examined. There was no difference between the two groups in terms of maternal age, gestational age and pregnancy history. The mean of cord blood pH in the nuchal cord group was 25/7(6.67-7.34) and in the group without nuchal cord, 7/27(6.94-9.37). This difference was statistically significant (p=0.005). There were no statistically significant differences in the other parameters related to umbilical cord blood gases (PCo2, Po2, HCo3 and Base excess) in the two groups. Also, there was no significant difference between the two groups in terms of birth weight, Apgar score at 1st and 5th minutes, median of active phase labor until delivery, type of delivery, fetal sex, meconium excretion and NICU need. Most majority had 1 umbilical cord around fetal neck. The mean of cord blood pH in neonates with one nuchal cord was lower than that of neonates with two or more nuchal cords, but there was no statistically significant (p=0.666). Other umbilical cord blood gases such as PCo2, Po2, HCo3 and base excess in single nuchal cord and infants with multiple nuchal cord were not statistically significant.Conclusion: The findings of this study showed that although the nuchal cord twist leads to a decrease in the PH of the arterial blood of the umbilical cord, however, this decrease is not significant in clinical terms. In other arterial blood gas parameters, there was no significant difference between two groups with and without nuchal cord. Even the multiple nuchal cord have no effect on arterial blood gases. Perhaps in studies with larger sample sizes and concurrent examination of arterial and venous blood gases, different results can be observed.

کلیدواژه ها:

Prenatal outcomes ، umbilical cord blood gases ، nuchal cord