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Fetal Nuchal Cord

  • Daniel Martingano and Francis X. Martingano
Published/Copyright: May 1, 2019
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Journal of Osteopathic Medicine
From the journal Journal of Osteopathic Medicine Volume 119 Issue 5

Keywords: biliary colic; cholelithiasis; nuchal cord

A 21-year-old woman, gravida 1, para 0, at 36.7 weeks’ gestation was evaluated for sudden-onset, acute abdominal pain. Physical examination findings were significant for positive Murphy sign and Chapman point on the right between the sixth and seventh rib. The patient was afebrile without leukocytosis. Magnetic resonance imaging of the abdomen and pelvis demonstrated cholelithiasis and an incidental finding of a single, type B nuchal cord (image A, asterisk and image B, arrows). A diagnosis of biliary colic secondary to cholelithiasis was made, and the patient was discharged home. At 39.6 weeks’ gestation, the patient had a labor course complicated by frequent variable decelerations, but she subsequently delivered a healthy male with Apgar scores of 9 and 9 at 1 and 5 minutes, respectively.

A loop of umbilical cord around the fetal neck is a common finding at delivery,1 and the incidence increases with advancing gestational age.2 Although it can cause variable decelerations in antenatal fetal heart rate monitoring, type A, reducible,3 and B, tight,4 nuchal cords are not associated with adverse perinatal outcomes.

From the Department of Obstetrics & Gynecology at the New York University Langone Hospital–Brooklyn.
Financial Disclosures: None reported.
Support: None reported.

*Address correspondence to Daniel Martingano, DO, New York University Langone Hospital–Brooklyn, 150 55th St, Brooklyn, NY 11220-2508. Email:

References

1. Collins JH . Nuchal cord type A and type B.Am J Obstet Gynecol. 1997;177(1):94.10.1016/S0002-9378(97)70444-7Search in Google Scholar

2. Clapp JF III , StepanchakW, HashimotoK, EhrenbergH, LopezB. The natural history of antenatal nuchal cords. Am J Obstet Gynecol. 2003;189(2):488-493.10.1067/S0002-9378(03)00371-5Search in Google Scholar

3. Sheiner E , AbramowiczJS, LevyA, SilbersteinT, MazorM, HershkovitzR. Nuchal cord is not associated with adverse perinatal outcome. Arch Gynecol Obstet. 2006;274(2):81-83.10.1007/s00404-005-0110-2Search in Google Scholar PubMed

4. Henry E , AndresRL, ChristensenRD. Neonatal outcomes following a tight nuchal cord. J Perinatol. 2013;33(3):231-234. doi:10.1038/jp.2012.79Search in Google Scholar PubMed

Received: 2018-09-11
Accepted: 2018-09-17
Published Online: 2019-05-01
Published in Print: 2019-05-01

© 2019 American Osteopathic Association

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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https://doi.org/10.7556/jaoa.2019.057
Keywords for this article
biliary colic; cholelithiasis; nuchal cord
Creative Commons
BY-NC-ND 4.0

Articles in the same Issue

  1. LETTERS TO THE EDITOR
  2. Doming the Diaphragm in a Patient With Multiple Sclerosis
  3. SURF
  4. Can Osteopathic Medical Students Accurately Measure Abdominal Aortic Dimensions Using Handheld Ultrasonography Devices in the Primary Care Setting?
  5. EDITORIAL
  6. The Art and Science of Osteopathic Medicine
  7. LETTERS TO THE EDITOR
  8. Renal Calculi Passage While Riding a Roller Coaster Has Ayurvedic Roots
  9. CORRECTION
  10. Correction
  11. AOA COMMUNICATION
  12. Official Call: 2019 Annual Business Meeting of the American Osteopathic Association
  13. Proposed Amendments to the AOA Constitution and Bylaws
  14. ORIGINAL CONTRIBUTION
  15. Gender Differences in Sexual Health Knowledge Among Emerging Adults in Acute-Care Settings
  16. Osteopathic Manipulative Medicine Consultations for Hospitalized Patients
  17. BRIEF REPORT
  18. Effects of Cannabis Use on Sedation Requirements for Endoscopic Procedures
  19. REVIEW
  20. Cynefin Framework for Evidence-Informed Clinical Reasoning and Decision-Making
  21. ART AND SCIENCE OF OSTEOPATHIC MEDICINE
  22. Why Does Clostridium difficile Infection Recur?
  23. CASE REPORT
  24. Complicated Withdrawal Phenomena During Benzodiazepine Cessation in Older Adults
  25. CLINICAL IMAGES
  26. Fetal Nuchal Cord
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