Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 13 , ISSUE 3 ( May-June, 2021 ) > List of Articles

CASE REPORT

A Rare Case Scenario of Sextuple Nuchal Cord Entanglement

Neethi Mala Mekala, Suneetha Allanki

Keywords : Six loops of cord, Cord around the fetal neck, Cord entanglement, Nuchal cord, Obstetric complications, Suspicious cardiotocography

Citation Information : Mekala NM, Allanki S. A Rare Case Scenario of Sextuple Nuchal Cord Entanglement. J South Asian Feder Obs Gynae 2021; 13 (3):194-195.

DOI: 10.5005/jp-journals-10006-1906

License: CC BY-NC 4.0

Published Online: 09-09-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Nuchal cord which means the presence of one or more loops of umbilical cord wrapped 360° around the fetal neck, is a common finding at delivery. It is one of the dynamic factors which is attributed to some unusual consequences during pregnancy and intrapartum period and can lead to operative intervention. The presence of multiple nuchal cord loops (>4) is infrequently reported in the literature. Case report: We report a rare case of sextuple (six loops) nuchal cord entanglement which was found during abdominal delivery in a woman who presented with labor pains and had persistent variable decelerations on cardiotocography. Conclusion: We infer that in the present case, though the presence of six loops of the nuchal cord was not diagnosed on antenatal ultrasonography, good APGAR scores and successful outcome were attributed to timely intervention based on good intrapartum surveillance. Clinical significance: Clinical management of nuchal cord entanglement remains an obstetric challenge. So far only two cases with multiple nuchal cord (more than five loops) were reported in the literature. We do report a rare picture of six loops of nuchal cord entanglement with good maternal and fetal outcome.


PDF Share
  1. Joshi K, Saxena R, Bhat M, et al. Incidence of cord around the neck and its effect on labour and neonatal outcome. Adv Hum Biol 2017;7:15–18. DOI: 10.4103/2321-8568.199535.
  2. Hansen HS, Hillersborg B. Antepartum looping of the umbilical cord. Acta Obstet Gynecol Scand 1988;67:475–476. DOI: 10.3109/00016348809004265.
  3. Sangwan V, Sangwan M, Siwach S, et al. Ultrasonographic detection of nuchal cord: required or not. Int J Reprod Contracept Obstet Gynecol 2014;3:507–511. Available at: https://www.ijrcog.org/index.php/ijrcog/article/view/982
  4. Mastrobattista JM, Hollier LM, Yeomons ER, et al. Effects of nuchal cord on birth weight and immediate neonatal outcome. Am J Perinatol 2005;22(2):83–85. DOI: 10.1055/s-2005-837737.
  5. Devendran D, Rabindran D, Dhwaraga J. A rare case of six loops of nuchal cord. Obs Gynecol Rev 2015;1(2), 30-33. DOI: 10.17511/joog.2015.i02.01.
  6. Henry E, Andres RL, Christensen RD. Neonatal outcomes following a tight nuchal cord. J Perinatol 2013;33:231. DOI: 10.1038/jp.2012.79.
  7. Larson JD, Rayburn WF, Crosby S, et al. Multiple nuchal entanglements and intrapartum complications. Am J Obstet Gynecol 1995;173(4):1228–1231. DOI: 10.1016/0002-9378(95)91359-9.
  8. Jouppila P, Kirkinen P. Ultrasonic diagnosis of nuchal encirclement by the umbilical cord: a case and methodological report. J Clin Ultrasound 1982;10:59–62. DOI: 10.1002/jcu.1870100205.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.