Nuchal cord

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Nuchal cord Classification and external resources
ICD-10	P02.5
ICD-9	762.5
MeSH	D053589

A nuchal cord occurs when the umbilical cord becomes wrapped around the fetal neck 360 degrees.

Contents 1 Classification 2 Diagnosis 3 Prognosis and treatment 4 References 5 External links

[edit] Classification

• A "Type A" nuchal cord is wrapped around the neck.
• A "Type B" nuchal cord is a hitch and is not wrapped. In the Type B case, a caesarian section delivery may be recommended but is not necessary.

[edit] Diagnosis

Doppler ultrasound has been successfully used to identify a Nuchal cord, and also to determine the orientation of the loop.

[edit] Prognosis and treatment

Nuchal cord can be managed by home fetal monitoring. It doesn't have a higher risk of birth complications. About 1 in 3 babies have the umbilical cord wrapped around their neck at the birth.

Cutting the umbilical cord should not be done until it has stopped pulsating (upwards of 20 minutes after birth).^{[citation needed]} In the case of a nuchal cord the child is still receiving blood and oxygen to the brain. As always the umbilical cord should not be cut until it ceases to pulsate (after all the blood from the placenta has been sent to the child.)^[1]

Checking for the presence of a nuchal cord is the second step in delivering a newborn in the pre-hospital setting. During a cephalic delivery, after the head presents the first step is to support the head and then use the middle finger to check for the presence of a nuchal cord. If one is discovered, an attempt to unwrap the cord is made. If the nuchal cord is wrapped too tightly around the newborns neck and cannot be corrected, it is clamped in two places and carefully cut to relieve the tension, preventing strangulation and other complications. (Emergency Care in the Streets(Textbook))

[edit] References

1. ^ www.cordclamp.com

[edit] External links

• Collins JH (2002). "Umbilical cord accidents: human studies". Semin. Perinatol. 26 (1): 79–82. PMID 11876571. 

v • d • e Certain conditions originating in the perinatal period (P, 760-779) Maternal factors and complications Umbilical cord prolapse - Nuchal cord - Chorioamnionitis Length of gestation and fetal growth Small for gestational age - Large for gestational age - Premature birth - Postmature birth Birth trauma Cephalhematoma - Brachial plexus lesion (Erb's palsy, Klumpke paralysis) Respiratory Intrauterine hypoxia - Infant respiratory distress syndrome - Transient tachypnea of the newborn - Meconium aspiration syndrome - pleural disease (Pneumothorax, Pneumomediastinum) - Wilson-Mikity syndrome - Bronchopulmonary dysplasia Cardiovascular Pneumopericardium - Persistent fetal circulation Haemorrhagic and haematological/ hematologic disease Haemorrhagic disease of the newborn - Hemolytic disease of the newborn - Rh disease - Hydrops fetalis - Hyperbilirubinemia (Kernicterus, Neonatal jaundice) Digestive system Ileus - Necrotizing enterocolitis Integument and temperature regulation Erythema toxicum Other disorders Periventricular leukomalacia - Gray baby syndrome - muscle tone (Congenital hypertonia, Congenital hypotonia) - Congenital rubella syndrome