Hong Kong study seeks to quell fears over condition that leads many to seek caesareans
Results of a newly published local survey suggest a majority of pregnant women in the city fear for the safety of their babies and think a caesarean section must be performed to treat a condition known as nuchal cord, even though the condition actually poses little risk to the fetus.
Nuchal cord describes the phenomenon when the umbilical cord wraps around the unborn baby's neck.
In the survey, led by Dr Meliza Kong Choi-wah of United Christian Hospital, women visiting antenatal clinics at both the UCH and Tseung Kwan O Hospital were given questionnaires about their understanding of the impact of nuchal cords.
A total of 869 questionnaires were received between August and October 2012. The results are to be published today in the latest issue of the .
Up to 87.7 per cent of respondents said they worried that a nuchal cord could cause fetal death during labour, while more than 70 per cent of them were under the impression that a caesarean section must be performed for those with the condition. A similar number of people felt early delivery was a necessary measure against nuchal cord.
The article about the study asserted that "misconceptions about the clinical implications of nuchal cord were widespread".
Although nuchal cord might lead to variable fetal heart rate decelerations, as shown by some studies, the article pointed out it "may not reflect clinically on fetal well-being".
Dr Robert Law Chi-lim, a private gynaecologist, said nuchal cord was common and one third of fetuses in the city had experienced the issue. However, as the impact is not significant, doctors do not usually seek it out.
Just because the cord was around the neck did not necessarily mean it was wrapped very tightly, "therefore problems would not appear", Law said.
The study also cited current research that found nuchal cord was not associated with increased neonatal intensive care unit admissions.
But the phenomenon commonly leads doctors on the mainland to perform caesarean sections, and researchers hoped to reduce the number of those unnecessary operations. Avoiding routine ultrasound scans for nuchal cords could also ease maternal anxiety, they said.
In cases of fetal heart rate deceleration, fetal blood sampling or assisted delivery is more appropriate, the study suggested.
