[Color Doppler flowmetry values in fetuses with nuchal cord encirclement].
In order to evaluate the presence of nuchal cord entanglement and to measure resistance index with Doppler color ultrasonography, a prospective, observational, cross-sectional study was carried out, 132 low risk term pregnant women were included, 50 of them had umbilical cord encirclement (37%), the sensitivity, specificity, positive predictive and negative predictive values were 92%, 87%, 81% and 95%, respectively. McNemar'test for discordance had a p = 0.121 in comparing ultrasonography result with the gold standard. Patients with nuchal cord entanglement had higher frequency of cesarean section (70%, p < 0.05) than those without it. On the other hand, normal vaginal delivery was more common (46%, p < 0.05) in patients without nuchal coiling of the umbilical cord. There were no significant difference in evaluating acute fetal distress, meconium stained amniotic fluid, newborn Apgar scores at one and five minutes, birth weight, neonatal intensive care unit admissions and intrapartum stillbirths. In our patients with nuchal cord entanglement the resistance index average values were 0.59 and those without nuchal cord were 0.60 (p = 0.712). We concluded that color flow Doppler ultrasonography is a reliable tool to detect nuchal coiling of the umbilical cord, and therefore Doppler color waveforms assessment in nuchal cord entanglements might helpful for clinicians to decide a closer surveillance in labor by using intrapartum cardiotocography.
Romero Gutiérrez
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G
Hospital de Ginecopediatría N. 48, Instituto Mexicano del Seguro Social, Unidad de Investigación en Epidemiología Clínica, León, Guanajuato.
Estrada Razo
S
S
Chávez Curiel
A
A
Ponce Ponce de León
A L
AL
D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005316:Fetal Distress / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D005333:Fetus / Q000098:blood supply*; D006801:Humans; D007231:Infant, Newborn; D008470:Meconium; D009333:Neck; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014470:Umbilical Cord / Q000000981:diagnostic imaging*; D014655:Vascular Resistance