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Management of Nuchal Cord With Multiple Loops

Wang, Yan MD, MSc; Le Ray, Camille MD, MSc; Audibert, François MD, MSc; Wagner, Marie-Soleil MD, MSc, FRCSC

doi: 10.1097/AOG.0b013e31816fd75c
Case Reports
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BACKGROUND: Nuchal cords are rarely associated with significant neonatal morbidity or mortality.

CASE: A primigravida with a normal term pregnancy presented for diminished fetal movement. Several nuchal cord loops were found on the ultrasound imaging, with normal Doppler findings. Abnormal fetal heart rate pattern appeared after 6 hours of labor. A cesarean delivery was performed. A healthy baby was born with eight nuchal cord loops.

CONCLUSION: The management of nuchal cord with a single loop, suspected before delivery, seems clear: it should not influence the clinical management. However, in this case, the previous knowledge of multiple nuchal loops may have influenced our decision to perform a cesarean delivery.

The optimum obstetric management of a nuchal cord with multiple loops is uncertain.

From the Department of Obstetrics and Gynecology, University of Montréal, St. Justine Hospital, Montréal, Québec, Canada.

Corresponding author: Marie-Soleil Wagner, MD, MSc, FRCSC Assistant Clinical Professor, Department of Obstetrics and Gynecology, University of Montréal, St. Justine Hospital, 3175 Chemin Côte-Ste-Catherine, Montréal, Québec, Canada, H3T 1N4; e-mail: marie-soleil.wagner.hsj@ssss.gouv.qc.ca.

Financial Disclosure The authors have no potential conflicts of interest to disclose.

© 2008 The American College of Obstetricians and Gynecologists