Prenatal detection and management of quadruple nuchal cord. A case report.

As imaging techniques improve, nuchal cords are often being identified prior to labor. Nuchal cords are encountered in up to 25% of deliveries and are usually not clinically significant. They may, however, have devastating results. Nuchal cords may be associated with abnormal fetal activity and testing, but there is often no clinical warning of a nuchal cord during pregnancy, labor or delivery. We report a case of a quadruple nuchal cord discovered after the mother complained of decreased fetal movement. The clinical course of this patient highlights many of the difficulties encountered in the management of antenatally diagnosed nuchal cords, particularly in the preterm fetus.