Silent Strangulation: A Case Report of the Unseen Threat of Nuchal Cord Discovered During Caesarean Section
DOI:
https://doi.org/10.4314/ajtmbr.v8i1.9Keywords:
Nuchal cord, Caesarean section, Fetal distress, Umbilical cord, Silent strangulationAbstract
Background: Nuchal cord one or more loops of umbilical cord around the fetal neck is a common finding, with global incidence ranging from 3% to 38%. Although typically benign, multiple or tightly wound loops may cause significant perinatal complications.
Case Presentation: We report a rare case of a 36-year-old primiparous woman induced at 41 weeks for postdatism and reduced fetal movements. Despite normal antenatal findings, persistent variable decelerations during labour prompted emergency caesarean section. Intraoperatively, three tight nuchal cord loops were discovered. The male neonate was delivered with moderate asphyxia (1-minute Apgar score 5) but responded to resuscitation, attaining 5-minute and 10-minute Apgar scores of 8 and 10, respectively.
Discussion and Conclusion: The case highlights the diagnostic limitations of routine antenatal ultrasonography in detecting tight nuchal cords, particularly in low-resource settings. It emphasizes the importance of individualized clinical assessment, vigilant monitoring during labour, and maintaining a high index of suspicion when fetal distress persists despite conservative interventions.
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