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Predictive factors for perinatal death in nuchal cord cases: a case control study

Pascal Foumane, Séraphin Nguefack, Jeanne Hortense Fouedjio, Aurélie Bitnkeu Assam, Julius Sama Dohbit, Emile Telesphore Mboudou.

Abstract
Background: Nuchal cord is a common occurrence at delivery and it is known to be associated with birth asphyxia and perinatal death. The objective of this study was to identify the predictive factors of perinatal death in the presence of nuchal cord.
Methods: This was a case-control study carried out during the period from October 1st 2014 to April 30th 2015 in three hospitals of Yaoundé, Cameroon, involving 204 parturients whose babies presented with a nuchal cord at delivery.
Results: After multivariate analysis, independent predictive factors for perinatal death in nuchal cord cases were: post-term (OR=209.70; CI= 3.09-14212.66), antepartum hemorrhage (OR=18.21; CI=1.47-224.78), fetal heart rate abnormalities during labor (OR=11.74; CI=1.33-103.37), augmentation of labor (OR=24.04; CI=1.85-311.52), second stage of labor lasting more than 30 minutes (OR=172.50; CI=20.60-1444.20) and tight nuchal cord at birth (OR=16.29; CI=2.07-127.87).
Conclusions: We recommend the identification of predictive factors for perinatal death in cases of known or suspected nuchal cord in order to consider cesarean section to prevent adverse fetal outcomes.

Key words: Cameroon, Nuchal cord, Predictive factors, Perinatal death


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