Risk factors of clinical birth asphyxia and subsequent newborn death following nuchal cord in a low-resource setting

Pascal Foumane, Gustave Nkomom, Emile Telesphore Mboudou, Julius Dohbit Sama, Séraphin Nguefack, Boniface Moifo

Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences (FMBS), The University of Yaoundé 1, Yaoundé, Cameroon.
Department of Pediatrics, Yaoundé Gyneco-Obstetric and Pediatric Hospital, Yaoundé, Cameroon.
Department of Radiology, Yaoundé Gyneco-Obstetric and Pediatric Hospital, Yaoundé, Cameroon.

DOI: 10.4236/ojog.2013.39117                

Abstract

Introduction: Our aim was to identify the risk factors of clinical birth asphyxia and subsequent newborn death in the presence of nuchal cord in a sub-Saharan Africa setting. Methodology: It was a six-months’ case-control study involving 117 parturients whose babies presented with a nuchal cord at delivery. The study was carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon, from January 1^st to June 30^th 2013. Results: The risk factors of clinical birth asphyxia identified were: first delivery, absence of obstetrical ultrasound during pregnancy, nuchal cord with more than one loop, duration of second stage of labor more than 30 minutes during vaginal delivery. The risk factors for newborn death from clinical birth asphyxia in the presence of nuchal cord were: maternal age < 20 years, first delivery, absence of obstetrical ultrasound during pregnancy, nuchal cord with more than one loop, tight nuchal cord, duration of second stage of labor more than 30 minutes during vaginal delivery. Conclusion: We recommend a systematic obstetrical ultrasound before labor, so as to detect the presence of a nuchal cord, its tightness and the number of loops. Also, cesarean section should be considered when a nuchal cord is associated with first delivery, tightness or multiple looping.

Keywords

Risk Factors; Nuchal Cord; Adverse Outcome; Birth Asphyxia; Newborn Death; Apgar Score; Cameroon

Conflicts of Interest

The authors declare no conflicts of interest.

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