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Re: Nuchal CordFrom: art fougner, md (evsono@pipeline.com)Sat Feb 28 13:56:39 2004
A pertinent article - J Ultrasound Med. 2004 Jan;23(1):43-7. Outcomes of pregnancies with sonographically detected nuchal cords remote from delivery. Gonzalez-Quintero VH, Tolaymat L, Muller AC, Izquierdo L, O'Sullivan MJ, Martin D. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, Florida, USA. vhgonzalez@med.miami.edu OBJECTIVE: To evaluate the outcomes of pregnancies with sonographically detected nuchal cords remote from delivery during the second and third trimesters of gestation. METHODS: A retrospective study of patients with and without nuchal cords detected by sonography during the second and third trimesters of gestation (17-36 weeks) was conducted. Variables included maternal age, parity, gestational age at sonography and at delivery, method of delivery, intrapartum fetal heart abnormalities, meconium-stained amniotic fluid, birth weight, 5-minute Apgar score, and neonatal intensive care unit admissions. RESULTS: A total of 233 patients were included in this study, of which 118 had sonographically detected nuchal cords identified in our department during the study period. There were no statistically significant differences between patients with sonographically detected nuchal cords and control patients with respect to maternal age, estimated gestational age at sonography, method of delivery, meconium-stained fluid, birth weight, intrapartum fetal heart abnormalities, 5-minute Apgar scores of less than 7, and neonatal intensive care unit admissions. Patients with nuchal cords detected by sonography were more likely to give birth before 37 weeks' gestation than control patients (21% versus 11%; P = .040). CONCLUSIONS: A sonographically detected nuchal cord is not associated with important perinatal complications. This last link between nuchal cord and preterm birth is intriguing. The authors commented:"To our knowledge, this study is the first to find an association between sonographically detected nuchal cords and preterm delivery, 21% in the nuchal cord group versus 11% in the control group. We cannot explain this finding on the basis of different rates of inductions or maternal complications because these were similar in the nuchal cord and control groups." Another observation - "...only 30% of the prenatally diagnosed nuchal cords persisted at delivery in our cases." Clearly, more study is necessary. art
At Fri, 27 Feb 2004, art fougner, md wrote:
>
-- art fougner, md ich bin ein New Yorker
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