UMBILICAL-CORD ENTANGLEMENT AND COLOR DOP PLER SONOGRAPHY

The incidence of umbilical cord entanglement is about 20-33%. The pres ent study describes the antepartal detection of nuchal cord using Colo ur Doppler sonography. In 137 cases, the identification of cord entang lement through a high resolution real-time Colour Doppler equipment (P icker 192/Acuson 128 XP) was achieved with sensitivity of 97%, the pos itive predictive value was 89%, the negative predictive value 96% and the efficiency 93%. In complicated cases, the pulsed Doppler sonograph y of the cord vessels provided significant differential diagnostic eva luation (Aa. and V umbilicales vs. uteroplacental vessels). The use of this new method is especially indicated in situations with uncertain variable decelerations and/or other abnormal findings in the anteparta l FHR-registration. The early recognition of a nuchal cord could possi bly prevent serious peri-/subpartal complications in many cases. The r esult of our investigations suggest, that once a cord entanglement has been identified sonographically, the antepartal cardiotocography, son ography, Doppler flow examination and intrapartal foetal monitoring sh ould be more frequently and intensively performed.