Nuchal cords are rarely associated with significant neonatal morbidity or mortality.
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.
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: firstname.lastname@example.org.
Financial Disclosure The authors have no potential conflicts of interest to disclose.