title: Nuchal cord: is it really the silent risk of pregnancy?
abstract: OBJECTIVE
  To evaluate the relationship between entanglement of umbilical cord around the fetal neck and adverse perinatal outcomes.
  
  
  METHODS
  In this prospective cohort study, perinatal outcomes of 218 pregnancies complicated with nuchal cord (NC) (study group) were compared with 190 uncomplicated pregnancies (control group). Main outcome measures were umbilical cord pH values, APGAR scores and cesarean section (C/S) rates. Fetal distress was stated as an abnormal heart rate pattern on electronic fetal heart monitorization.
  
  
  RESULTS
  There were no statistically significant differences in maternal demographic and obstetric features, between groups. There were no statistically significant differences regarding C/S rates between groups, even though fetal distress was significantly the leading indication for cesarean delivery, in the study group (p = 0.021). The number of entanglement was significantly related with fetal distress (p < 0.001). There were no statistically significant differences in umbilical cord gas values, one-minute and five-minute APGAR scores between the groups. Furthermore, there was a significant male dominance in the study group (p = 0.014) and also, amniotic fluid indexes (AFI) were significantly higher in this group (p = 0.002).
  
  
  CONCLUSIONS
  This study demonstrated that, entanglement of umbilical cord around the fetal neck or NC is not related with adverse perinatal outcomes such as acidosis and low APGAR scores. So that, a targeted care on NC via ultrasound during labor, is not an essential part of the examination.
authors: a Department of Gynecology and Obstetrics , Kayseri Training and Research Hospital , Kayseri , Turkey.
authors: Hatice
authors: H
authors: Akkaya
authors: a Department of Gynecology and Obstetrics , Kayseri Training and Research Hospital , Kayseri , Turkey.
authors: Barış
authors: B
authors: Büke
authors: b Obstetrics and Gynecology Medicine, Dr Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey.
authors: Meryem Kuru
authors: MK
authors: Pekcan
authors: c Gynecology and Obstetrics Clinic, Kayseri Memorial Private Hospital , Kayseri , Turkey , and.
authors: Kıvanç
authors: K
authors: Şahin
authors: a Department of Gynecology and Obstetrics , Kayseri Training and Research Hospital , Kayseri , Turkey.
authors: Gülsüm
authors: G
authors: Uysal
authors: d Department of Gynecology and Obstetrics , Ankara Atatürk Training and Research Hospital , Ankara , Turkey.
authors: Gülin Feykan
authors: GF
authors: Yeğin
authors: d Department of Gynecology and Obstetrics , Ankara Atatürk Training and Research Hospital , Ankara , Turkey.
authors: Ayşe Filiz
authors: AF
authors: Avşar
authors: a Department of Gynecology and Obstetrics , Kayseri Training and Research Hospital , Kayseri , Turkey.
authors: Fulya
authors: F
authors: Çağlı
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D053589:Nuchal Cord / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
keywords: APGAR; Nuchal cord; pregnancy outcomes; umblical cord blood gas