Impact of wrapped umbilical cord on the incidence of operative delivery

Abstract

Introduction: The incidence of umbilical cord wrapped around foetus’ body parts at birth in the Slovenian population is not yet known. According to the statistics from foreign countries, the incidence of wrapped cord during labour is 6% to 37%. In addition, it is not known whether wrapped cord affects the occurrence of foetal distress during labour and leads to a higher incidence of operative delivery. Methods: The research used the retrospective cohort study based on the data from the National Perinatal Information System. We analysed the data for period 2002 through 2011. We have included all deliveries between 37 0/7 and 41 6/7weeks. Chi-square test was used to determine the relationship between wrapped umbilical cord and operative delivery (operative vaginal delivery - vacuum, forceps or caesarean section) (p<0.05 significant). Multivariate logistic regression was used to analyse the impact of wrapped cord on operative delivery controlling for potentially confounding factors: labour duration ≥ 9hours, birth weight<5th centile for gestational age, and onset of labour (induction vs. spontaneous). Results: We included 173776 deliveries. Among these, a nuchal cord was present in 57174 cases (33 %). In the univariate analysis, the nuchal cord was significantly associated with operative delivery due to foetal distress (p < 0.001). In multivariate analysis, however, nuchal cord was not an independent risk factor for the operative delivery (p = 0,311), as were the first pregnancy, prolonged labour, induction and SGA (birth weight<5th centile). Discussion and conclusion: The incidence of nuchal cord in term deliveries in Slovenia is ...