Cliniques en santé maternelle et infantile

Abstrait

Nuchal Cord and Perinatal Outcome at the Yaounde General Hospital, Cameroon

J. D. Kemfang Ngowa, J. M. Kasia, I. Nsangou, C. Zedjom, I. Domkan, F. Morfaw,and B. Bossiko

The aim of this study was to determine the incidence of nuchal cord at delivery and perinatal outcome. We conducted a retrospective descriptive study from 1992–2008 at the Yaounde General Hospital. Obstetrical and neonatal variables were compared in the loose and tight nuchal cord groups and a control group (no nuchal cord). Of 9275 deliveries recorded, 16.2% had a nuchal cord. Of these nuchal cords, 75.81% were loose and 24.18% were tight. Cesarean delivery rate was lower in the loose and tight nuchal cord groups when compared with control group (P <.001;P < .05). Low Apgar scores < 7 at the 1st and 5th minutes were less in the loose nuchal cord group when compared with control group (P = .06, P = .7). In tight nuchal cord group, low Apgar score < 7 at the 1st minute was significantly higher, when low Apgar score < 7 at the 5th minute was non significantly higher when compared with control group (P < .001, P = .14). Transfer rate to neonatology unit was lower in the loose and tight nuchal cord than in the control group. Loose nuchal cord may not be associated with adverse perinatal outcome. However, tight nuchal cord may be associated with increased risk of low Apgar score < 7 at the 1st minute. Consequently, the ultrasound diagnosis of a nuchal cord at the end of pregnancy should not be the indication of elective cesarean delivery.