Effect of Umbilical Cord Abnormalities on Fetal Heart Pattern Leading to Operative Delivery


ABSTRACT:BACKGROUND:Umbilical cord abnormalities may be associated with fetal heart rate irregularities this mightchange the mode of delivery from vaginal delivery to cesarean delivery and may be responsible foradverse perinatal outcomes.OBJECTIVE:To verify the association between umbilical cord abnormalities and fetal heart irregularities thatlead to urgent cesarean delivery.MATERIALS AND METHODS:One hundred and six full term singleton pregnant women were enrolled in this study, 51 of themdeveloped non reassuring fetal heart rate (Abnormal CTG) and emergency cesarean delivery wasdone for them, those represent the study group, the other 55 women had reassuring CTG anddelivered vaginally, those represent control group. Umbilical cord and the neonate were examinedafter delivery for abnormality. The data obtained were fixed on questionnaire papers and thensubjected to analysis.RESULTS:Umbilical cord abnormalities were present in higher significant rate (43.1%) in emergencycesarean delivery group than vaginal delivery group. Although single umbilical cord abnormalitieswas present more than multiple umbilical cord abnormalities but the latter associated significantlywith increase rate of cesarean delivery (P value is 0.05). Nuchal cord was present in (31.3%) ofwomen of study group and in (16.4%) of control group. The most fetal heart abnormality foundwas fetal deceleration (96.1%) and most commonly was late deceleration (42.8%).Newborns with multiple umbilical cord abnormalities had significantly lower weight and lowerApgar scores than those with single cord abnormalities, P value 0.018, 0.037 respectively.CONCLUSION:Umbilical cord abnormalities are associated with increase rate of cesarean delivery because of fetalheart rate irregularities. The most common abnormality is umbilical cord entanglement around thefetal neck.Multiple umbilical cord entanglement are responsible significantly for increased cesarean rate andadverse perinatal outcomes.