Abstract
Using cardiotocogram and umbilical arterial gas analysis, the presence or absence and variations of umbilical cord coiling were examined with relation to the incidence of variable deceleration (V.D.) and neonatal asphyxia. The results obtained were as follows.
1) The incidence of V.D. with cord coiling was higher than that without cord coiling (p<0.005). The incidence of severe V.D. with cord coiling was also higher than that without cord coiling (p<0.005).
2) The mean Apgar scores of cases with cord coiling were lower than that without cord coiling (p<0.02).
3) On the umbilical arterial gas analysis, the mean pH of cases with cord coiling was lower than that without cord coiling (p<0.05). And the mean pCO2 of cases with cord coiling was higher than that without cord coiling (p<0.005). So neonate with cord coiling showed a tendency towards respiratory acidosis in comparison with that without cord coiling.
4) The incidence of neonatal asphyxia with cord coiling was 16.0% (Apgar score≤7), 20.0% (pH<7.20) and that without cord coiling was 8.8%, 13.2%, respectively. Although there was no statistically significant difference, a tendency was observed towards a higher rate of neonatal asphyxia with cord coiling.
5) The incidence of neonatal asphyxia with severe V.D. was 44.4% (Apgar score≤7), 36.1% (pH<7.20) and that without severe V.D. was 5.7%, 8.6%, respectively. There was a statistically significant difference (p<0.005, p<0.005). In addition, the incidence of neonatal asphyxia with repeated V.D. was 35.3% (Apgar score≤7), 44.1% (pH<7.20) and without repeated V.D. was 3.8%, 6.5%, respectively. There was a statistically significant difference (p<0.005, p<0.005).
6) There was a statistically significant change in the incidence of repeated V.D. with cord coiling and without cord coiling (p<0.005). And especially, with tight cord coiling, there was a significant increase in the incidence of repeated V.D. (p<0.05), or in the insidence of severe V.D. (p<0.05). Moreover, the incidence of neonatal asphyxia with tight cord coiling was 62.5% (Apgar score≤7), 62.5% (pH<7.20). There was a statistically significant increase in comparison with the control (p<0.005, p<0.005).
