A rare case scenario of sextuple nuchal cord entanglement

Abstract

Background: Nuchal cord which means the presence of one or more loops of umbilical cord wrapped 360° around the fetal neck, is a common finding at delivery. It is one of the dynamic factors which is attributed to some unusual consequences during pregnancy and intrapartum period and can lead to operative intervention. The presence of multiple nuchal cord loops (>4) is infrequently reported in the literature. Case report: We report a rare case of sextuple (six loops) nuchal cord entanglement which was found during abdominal delivery in a woman who presented with labor pains and had persistent variable decelerations on cardiotocography. Conclusion: We infer that in the present case, though the presence of six loops of the nuchal cord was not diagnosed on antenatal ultrasonography, good APGAR scores and successful outcome were attributed to timely intervention based on good intrapartum surveillance. Clinical significance: Clinical management of nuchal cord entanglement remains an obstetric challenge. So far only two cases with multiple nuchal cord (more than five loops) were reported in the literature. We do report a rare picture of six loops of nuchal cord entanglement with good maternal and fetal outcome.