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

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-Ob- stetric and Pediatric Hospital, Cameroon, from Janu- ary 1st to June 30th 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 be- fore labor, so as to detect the presence of a nuchal cord, its tightness and the number of loops. Also, ce- sarean section should be considered when a nuchal cord is associated with first delivery, tightness or multiple looping.