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Nuchal cord

**Nuchal cord**
*Classification & 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.

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1 Classification
2 Diagnosis
3 Prognosis and treatment
4 References

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.

Diagnosis

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

Prognosis and treatment

Nuchal cord can be managed by home fetal monitoring. Nuchal cord can be a cause of stillbirth but can also be prevented.

Cutting the umbilical cord should not be done until it has stopped pulsating (upwards of 20 minutes after birth). 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]

References

^ www.cordclamp.com

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 and cardiovascular	Intrauterine hypoxia - Infant respiratory distress syndrome - Transient tachypnea of the newborn - Meconium aspiration syndrome - Pneumomediastinum - Wilson-Mikity syndrome - Bronchopulmonary dysplasia
Haemorrhagic and haematological	Hemorrhagic disease of newborn - Hemolytic disease of the newborn - Rh disease - Hydrops fetalis - Kernicterus - Neonatal jaundice
Digestive system	Ileus - Necrotizing enterocolitis
Integument and temperature regulation	Erythema toxicum
Other disorders	Periventricular leukomalacia - Congenital hypertonia - Congenital hypotonia - Congenital rubella syndrome