OBJECTIVE: To study the contribution of umbilical cord (UC) abnormalities in emergent cesarean deliveries (ECDs) for non-reassuring fetal heart rate (NRFHR) and to explore their association with placental histopathology and neonatal outcome. STUDY DESIGN: Data from 530 ECDs for NRFHR were reviewed for the occurrence of @entity602 . Those included the presence of UC entanglements, the number and location of loops, true knots and @entity602 (<50 cm). Multiple UC entanglements were defined as     2 UC loops. Results were compared with 530 vaginal deliveries (VD group) matched for maternal age, parity and gestational age. Additionally, we compared neonatal outcome and placental histopathology in cases of ECDs with a single vs multiple UC entanglements. Neonatal outcome consisted of low Apgar score (    7 at 5 min), cord blood pH     7.1 and composite neonatal outcome that was defined as one or more of respiratory distress, @entity3166 , @entity295 , transfusion, ventilation, @entity410 , @entity2806 , phototherapy or @entity204 . Placental lesions were classified as: lesions related to maternal vascular supply, lesions related to fetal vascular supply (consistent with fetal @entity432 ), and maternal and fetal inflammatory responses. RESULTS: UC entanglements, true knots and short cords were all more common in the ECD group compared with the VD group, P<0.001, P=0.002, P=0.004, respectively. The rate of one loop entanglement did not differ between the groups. The rate of multiple UC entanglements was higher in the ECD group compared with the VD group, 20.6% vs 6.4%, respectively, P<0.001. ECDs with multiple compared with single UC entanglement had higher rate of adverse neonatal outcome, P=0.031, and more @entity455 19.3% vs 8.1%, P=0.027, respectively. CONCLUSION: Multiple UC entanglements, true knots and short cords were more common in ECDs for NRFHR, suggesting their role in the development of fetal @entity455 and adverse neonatal outcome.

The association between XXXX and the development of non-reassuring fetal heart rate leading to emergent cesarean deliveries.

@entity410 :: ('MESH:D012640', 'Disease') :: ['seizure'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity3166 :: ('MESH:D020345', 'Disease') :: ['necrotizing enterocolitis'] @entity455 :: ('MESH:D014652', 'Disease') :: ['placental fetal vascular lesions', 'placental vascular lesions'] @entity2806 :: ('MESH:D002545', 'Disease') :: ['hypoxic-ischemic encephalopathy'] @entity602 :: ('MESH:D013118', 'Disease') :: ['UC abnormalities', 'short cord'] @entity432 :: ('MESH:D001157', 'Disease') :: ['thrombo-occlusive disease'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity602 :: (MESH:D013118,Disease) :: ['umbilical cord abnormalities']
