Nuchal Cord

Outline
Introduction
• A loop of umbilical cord around the fetal neck (nuchal cord) is a
common finding at delivery.

• Doesn’t increase the rate of any clinically important outcome in most

case
• In some cases, tight nuchal cords were associated with adverse outcomes,
including fetal asphyxia and demise
• Causality often cannot be proven
Classification
• Single or multiple
• Loose or tight (ie, compressing the fetal neck)
• Type A or B

can become undone can form a true knot when it passes

with fetal movement caudally over the fetal body
Pathogenesis
• The occurrence of a nuchal cord appears to be a random event
• Increased risk among fetuses with excessive movement and/or a long
umbilical cord (≥70 cm in length)

Natsuko Kobayashi et al., Obstetrics and Gynecology International, 2015

Incidence
• The incidence increases with increasing gestational age

Janet D. Larson et al., AMERICAN JOURNAL OF PERINATOLOGY, 1997

Incidence
• Single nuchal cords are more common than multiple nuchal cords
• More frequent in whites and in deliveries of male infants

Janet D. Larson et al., AMERICAN JOURNAL OF PERINATOLOGY, 1995