Nuchal cord x4!

tryingtomakeit, RN · Jul 3, 2006

One of my coleagues had a had a pt deliver by c/s yesterday with a nuchal cord x4! The mom cam in for a labor check, 5cm, ctx q5 min, FHR 165, no accels, decreased variabliity, repetative lates. FP plan with OB consult, get IV access, secure epidural, rupture, internalize, make decision, c/s called after 5 hours of watching same tracing.
None of our staff could remember ever hearing about one like this. Anybody else ever seen/hear about a quadraple nuchal cord?

Last year I saw a nuchal x5 with TWO true knots. Unfortunately the mother had come in because she hadn't felt the baby move in a while - sure enough there were no FHT's. MD did and ultrasound and it was too late. We sectioned the mom and were speechless to find the cord like that. So sad.

anniesong · Jul 3, 2006

I've seen a nuchal cord x5 on the second born of 30 week twins. Twin A was born lady partslly (becuse frankly by the time she came in there wasn't time for anything else), then they had to do a stat c/s on twin B when she couldn't be turned and began having decels... and it's a darn good thing.

My preceptor commented on how the fact that mom went into labor so prematurely probably gave B the best chance she could have had. Unfortunately I don't know how well they ultimately did because they were transferred out to another hospital.

babyktchr, BSN, RN · Jul 3, 2006

a good friend came in for routine NST and had completely flat line. after a BPP of 2/8, they sectioned this 36 week baby to find a nuchal cord x7. the baby's neck was hyperextended from the anaconda around her neck. poor thing....she had a bit of respiratory difficulties and was transported to a tertiary care facility. she is now 9. it was one of the most amazing things i have ever seen. thank goodness she came in for NST that day.

PegRNBSN · Jul 3, 2006

Was working when 37 weeks pregnant with my second. He was a very active baby and wasn't moving much. Put myself on the monitor in the morning and it was flat. Got busy with work and before I left for the day put myself back on the monitor. This time no variability and huge variables.

They tried to induce but baby wouldn't tolerate, crash c/s, nuchal cordx3 and around the shoulder, under the armpit. Cord tore right at his abdomen as they delivered him (they had to stitch it as there wasnt enough to clamp.

He was only 4#14 oz (my first was 8# 4 oz) they think because of compromised blood flow. I had polyhydramnios so this disguised the fact baby was so small.

Being an OB nurse saved my baby!!

Every birthday the first thing he says to me is "Thanks for saving my life"

He's 18 now

madwife2002, BSN, RN · Jul 3, 2006

Normally an indication of some kind of abnormality I expect tests will have to be run.

Jolie, BSN · Jul 3, 2006

We had a mom who called her OB at 31 weeks complaining of decreased fetal movement. The OB sent her over for monitoring, commenting that she was a PIA patient, and he doubted that there was anything wrong. He was just going to "humor" her and send her home. On the monitor, she was having repeated decels with fetal movement. During the night, she had a prolonged decel down to the 60's, at which time, the OB's partner sectioned her.

The baby came out with a cord that was as tangled and knotted as anything I have ever seen. It looked like a telephone cord that needed to be "unraveled". That baby was the sickest 31 weeker I have ever cared for, but went home to a loving family who truly appreciated the near-loss they had experienced. Last time I saw him, he was a chubby, healthy 3 year old.

Faeriewand, ASN, RN · Jul 3, 2006

Was working when 37 weeks pregnant with my second. He was a very active baby and wasn't moving much. Put myself on the monitor in the morning and it was flat. Got busy with work and before I left for the day put myself back on the monitor. This time no variability and huge variables.
They tried to induce but baby wouldn't tolerate, crash c/s, nuchal cordx3 and around the shoulder, under the armpit. Cord tore right at his abdomen as they delivered him (they had to stitch it as there wasnt enough to clamp.
He was only 4#14 oz (my first was 8# 4 oz) they think because of compromised blood flow. I had polyhydramnios so this disguised the fact baby was so small.
Being an OB nurse saved my baby!!
Every birthday the first thing he says to me is "Thanks for saving my life"
He's 18 now

What a beautiful ending to your story..... and beautiful son. :)

RNLaborNurse4U · Jul 3, 2006

a good friend came in for routine NST and had completely flat line. after a BPP of 2/8, they sectioned this 36 week baby to find a nuchal cord x7. the baby's neck was hyperextended from the anaconda around her neck. poor thing....she had a bit of respiratory difficulties and was transported to a tertiary care facility. she is now 9. it was one of the most amazing things i have ever seen. thank goodness she came in for NST that day.

Wow oh wow.....lucky baby!! That is by far the most I have ever heard. I have seen some triple nuchals, some true knots with double/triple nuchals, and I have had a girlfriend with a nuchal x4.

Wow......7.

SmilingBluEyes · Jul 4, 2006

nope, but saw a triple and bandolier. IT was the LONGEST cord I EVER saw. Baby was just fine.

LaNICUnurse · Jul 4, 2006

nope, but saw a triple and bandolier. IT was the LONGEST cord I EVER saw. Baby was just fine.

These are some amazing stories, I think the most I've seen is 3. And, 2 true knots.

What is a bandolier?

SmilingBluEyes · Jul 4, 2006

cord wrapped around the body, like a bullet bandolier on an old western.