Study of length of umbilical cord and fetal outcome: a study of 1,000 deliveries.

OBJECTIVE: To study the correlation of umbilical cord length with fetal parameters like Apgar score, sex, weight, and length, and its effect on labor outcome.

DESIGN: Prospective study of 1,000 cases.

SETTING: Government Hospital.

MATERIAL AND METHOD: Examination of umbilical cord was done for any loop around neck, trunk, etc; no. of loops of cord and positions; Knots of cord (True or false), any cord abnormalities. Fetal parameters recorded were sex, weight, and length of the newborn. Fetal outcome studied by Apgar score at 1 and 5 min.

RESULTS: In our study, the cord length varied from 24 to 124 cm. The mean cord length was 63.86 cm (±15.69 cm). Maximum cases seen were in the group of cord length between 51 and 60 cm. Lower 5th percentile was considered as short cord and upper 5th percentile was considered as long cord. Short-cord group was associated with significantly higher (p < 0.05) incidence of LSCS cases. Cord length did not vary according to the weight, length, and sex of the baby. The incidence of all types of cord complications increases as the cord length increases (p < 0.001*). Nuchal cords had higher mean cord length than in cases without nuchal cords (p < 0.001). As the number of loops in a nuchal cord increases to more than two loops, the operative interference increases. The significance was tested by using a Chi-square test, and it was found to be statistically significant (p < 0.05). Nuchal cords were seen to be associated with more cases of fetal heart abnormalities (p < 0.001). There is higher incidence of variability in fetal heart rate with extremes of cord length (p < 0.001). The incidence of birth asphyxia was significantly more in long and short cords as compared to cords with normal cord length (p < 0.001).

CONCLUSION: The present study showed that the length of umbilical cord is variable; however, maximum number of cases had normal cord length. Cases which had short and long cords constituted abnormal cord length. These cases had higher incidence of cord complications, increased incidence of operative interference, intrapartum complications, increased fetal heart rate abnormalities, and more chances of birth asphyxia. But cord length did not vary according to the weight, length, and sex of the baby.