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Paper Title: Triple nuchal cord, intrauterine fetal death in a multipara with two previous caesarean sections: A case report

Authors: Eli S., Onumbu K., Abbey M., Nonye-Enyindah E., Allagoa D., Okagua K.

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Nuchal cords are causes of concern to the Obstetricians/Gynaecologists especially with respect to fetal outcome. The prevalence of nuchal cord is between 6% to 37% deliveries globally. Perinatal mortality is commoner with multiple nuchal cords compared with single nuchal cord.

The aim is to present this clinical entity and create awareness on its management modalities.

Case Report:
+0 Mrs. OT is a 31-year old booked G3 Para 2 (2 alive), a known Hb SS diseased mother with two previous caesarean sections presented at the antenatal clinic at 36 week gestation with a 2 day history of absence of fetal movement. Intrauterine fetal demise was confirmed with an obstetric ultra sound scan, which also showed positive Roberts and Spaldings signs. The antenatal period was before now uneventful. She was diagnosed with an unexplained intrauterine fetal death, and subsequently
had an elective repeat caesarean section. The cause of death was noted to have resulted from triple nuchal cord. Her postoperative period was uneventful. She was discharged on her 7 post-operative day.

Nuchal cord like other cord accidents, are not easily diagnosed. However, with the application of routine fetal surveillance especially by the use of Doppler ultrasound scan, the diagnosis of nuchal cord may be made especially in proficient hands.

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