{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:57:23Z","timestamp":1790812643011,"version":"4.1.0"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Geburtshilfe Neonatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This retrospective cohort study aimed to evaluate the impact of a nuchal cord\n                        at birth on the pulsatility indices of the umbilical artery, the middle\n                        cerebral artery, and the cerebroplacental ratio, assessed by Doppler\n                        ultrasound within 7 days before delivery. Secondary objectives included\n                        assessing the associations between the presence of a nuchal cord and a tight\n                        nuchal cord with adverse neonatal outcomes, as well as the correlations\n                        between the number of cord loops and Doppler indices and umbilical cord\n                        blood gas values.<\/jats:p>\n                  <jats:p>Data from 203 singleton pregnancies with Doppler ultrasound performed within\n                        7 days before delivery were analyzed. Participants were grouped according to\n                        the presence or absence of nuchal cord at birth. Doppler parameters\n                        (umbilical artery pulsatility index, middle cerebral artery pulsatility\n                        index, and cerebroplacental ratio) and clinical variables, including\n                        arterial and venous umbilical cord blood pH, Apgar scores, birth weight, and\n                        adverse perinatal events, were evaluated.<\/jats:p>\n                  <jats:p>The presence of a nuchal cord or a tight nuchal cord at birth did not affect\n                        the Doppler parameters in obstetric ultrasound examinations conducted up to\n                        7 days prior to delivery. The presence of a nuchal cord was not\n                        significantly associated with adverse perinatal outcomes. A weak but\n                        statistically significant positive correlation was observed between the\n                        number of cord loops and the middle cerebral artery pulsatility index, with\n                        no significant correlation with the umbilical artery pulsatility index,\n                        cerebroplacental ratio, or umbilical cord blood pH values.<\/jats:p>\n                  <jats:p>These findings suggest that the presence of a nuchal cord does not impact the\n                        pulsatility index of the umbilical artery, middle cerebral artery, and\n                        cerebroplacental ratio, assessed by Doppler ultrasound within 7 days before\n                        delivery. Further research is needed to clarify the clinical\n                        implications.<\/jats:p>","DOI":"10.1055\/a-2956-6022","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:28:35Z","timestamp":1790810915000},"source":"Crossref","is-referenced-by-count":0,"title":["Umbilical and Middle Cerebral Artery Pulsatility Indices as\n                    Predictors of a Nuchal Cord: A Retrospective Cohort Study"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0925-0742","authenticated-orcid":false,"given":"Laura Beatriz","family":"Carvalho Oliveira","sequence":"additional","affiliation":[{"name":"Mario Palm\u00e9rio University Hospital \u2013 University of Uberaba\n                    (UNIUBE), MG, Brazil","place":["Uberaba"],"department":["Gynecology and Obstetrics Service"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2550-8059","authenticated-orcid":false,"given":"Luisa Fernandes","family":"Andrade","sequence":"additional","affiliation":[{"name":"Mario Palm\u00e9rio University Hospital \u2013 University of Uberaba\n                    (UNIUBE), MG, Brazil","place":["Uberaba"],"department":["Gynecology and Obstetrics Service"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6694-6569","authenticated-orcid":false,"given":"Gustavo Yano","family":"Callado","sequence":"additional","affiliation":[{"name":"Albert Einstein Israelite Hospital, SP, Brazil","place":["S\u00e3o Paulo"],"department":["Albert Einstein Israelite College of Health Sciences\n                    (FICSAE)"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8010-1647","authenticated-orcid":false,"given":"Anna Moreira","family":"Herval","sequence":"additional","affiliation":[{"name":"Mario Palm\u00e9rio University Hospital \u2013 University of Uberaba\n                    (UNIUBE), MG, Brazil","place":["Uberaba"],"department":["Gynecology and Obstetrics Service"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8011-6818","authenticated-orcid":false,"given":"Clara Trajano","family":"Borges","sequence":"additional","affiliation":[{"name":"Mario Palm\u00e9rio University Hospital \u2013 University of Uberaba\n                    (UNIUBE), MG, Brazil","place":["Uberaba"],"department":["Gynecology and Obstetrics Service"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1836-303X","authenticated-orcid":false,"given":"Eduardo Moreira","family":"Nader","sequence":"additional","affiliation":[{"name":"Paulista\n                        School of Medicine, Federal University of S\u00e3o Paulo\n                        (EPM-UNIFESP), SP, Brazil","place":["S\u00e3o Paulo"],"department":["Department of Obstetrics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2942-6182","authenticated-orcid":false,"given":"Antonio","family":"Braga","sequence":"additional","affiliation":[{"name":"School of Medicine, Maternity School, Federal University of Rio de\n                    Janeiro (UFRJ), RJ, Brazil","place":["Rio de Janeiro"],"department":["Department of Gynecology and Obstetrics"]},{"name":"School of Medicine and Surgery, Federal University of the State of Rio\n                    de Janeiro (UNIRIO), RJ, Brazil","place":["Rio de Janeiro"],"department":["Department of General and Specialized Surgery"]},{"name":"University of Vassouras (Univassouras), RJ, Brazil","place":["Vassouras"],"department":["Postgraduate Program in Applied Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-2532","authenticated-orcid":false,"given":"Edward","family":"Araujo J\u00fanior","sequence":"additional","affiliation":[{"name":"Paulista\n                        School of Medicine, Federal University of S\u00e3o Paulo\n                        (EPM-UNIFESP), SP, Brazil","place":["S\u00e3o Paulo"],"department":["Department of Obstetrics"]},{"name":"Municipal University of S\u00e3o Caetano do Sul\n                    (USCS), SP, Brazil","place":["S\u00e3o Caetano do Sul"],"department":["Discipline of Woman\n                    Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1655-3609","authenticated-orcid":false,"given":"Alberto Borges","family":"Peixoto","sequence":"additional","affiliation":[{"name":"Mario Palm\u00e9rio University Hospital \u2013 University of Uberaba\n                    (UNIUBE), MG, Brazil","place":["Uberaba"],"department":["Gynecology and Obstetrics Service"]},{"name":"Federal University of Tri\u00e2ngulo Mineiro (UFTM), MG, Brazil","place":["Uberaba"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s40748-017-0068-7","article-title":"Nuchal cord and its implications","volume":"3","author":"M Peesay","year":"2017","journal-title":"Matern Health Neonatol Perinatol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1067\/s0002-9378(03)00371-5","article-title":"The natural history of antenatal nuchal cords","volume":"189","author":"J F Clapp 3rd","year":"2003","journal-title":"Am J Obstet Gynecol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/s00404-005-0110-2","article-title":"Nuchal cord is not associated with adverse perinatal outcome","volume":"274","author":"E Sheiner","year":"2006","journal-title":"Arch Gynecol Obstet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"6836","DOI":"10.3390\/jcm13226836","article-title":"The nuchal cord conundrum: understanding and addressing umbilical entanglement\n                    in the third trimester of pregnancy","volume":"13","author":"J Murlewska","year":"2024","journal-title":"J Clin Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1730","DOI":"10.1080\/14767058.2016.1223035","article-title":"Nuchal cord: is it really the silent risk of pregnancy?","volume":"30","author":"H Akkaya","year":"2017","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1038\/jp.2012.79","article-title":"Neonatal outcomes following a tight nuchal cord","volume":"33","author":"E Henry","year":"2013","journal-title":"J Perinatol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1002\/jcu.10211","article-title":"Prenatal color Doppler sonographic evaluation of nuchal encirclement by the\n                    umbilical cord","volume":"31","author":"U Aksoy","year":"2003","journal-title":"J Clin Ultrasound"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"526.e1","DOI":"10.1016\/j.ajog.2007.04.002","article-title":"Determinants of the middle cerebral artery peak systolic velocity in the human\n                    fetus","volume":"197","author":"A H Picklesimer","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"6170","DOI":"10.3390\/jcm12196170","article-title":"Prenatal echo-sonographic parameters in fetuses wrapped with the umbilical cord\n                    in the third trimester of pregnancy","volume":"12","author":"J Murlewska","year":"2023","journal-title":"J Clin Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/j.gofs.2024.07.005","article-title":"Fetal death: expert consensus from the College of French Gynecologists and\n                    Obstetricians","volume":"52","author":"C Garabedian","year":"2024","journal-title":"Gynecol Obstet Fertil Senol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1097\/GRF.0000000000000104","article-title":"Intrapartum fetal monitoring","volume":"58","author":"A G Cahill","year":"2015","journal-title":"Clin Obstet Gynecol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1002\/uog.23619","article-title":"ISUOG Practice Guidelines (updated): use of Doppler velocimetry in\n                    obstetrics","volume":"58","author":"A Bhide","year":"2021","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1002\/uog.1945","article-title":"Reference ranges for serial measurements of blood velocity and pulsatility index\n                    at the intra-abdominal portion, and fetal and placental ends of the umbilical\n                    artery","volume":"26","author":"G Acharya","year":"2005","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1002\/pd.1859","article-title":"Fetal arterial and venous Doppler pulsatility index and time-averaged velocity\n                    ranges","volume":"27","author":"M Parra-Cordero","year":"2007","journal-title":"Prenat Diagn"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1002\/uog.13","article-title":"The cerebroplacental Doppler ratio revisited","volume":"21","author":"A A Baschat","year":"2003","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1055\/a-1787-7408","article-title":"Umbilical artery cord gas abnormalities in the presence of a nuchal cord in term\n                    singleton pregnancies: a cohort study","volume":"41","author":"L D Zahedi-Spung","year":"2024","journal-title":"Am J Perinatol"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239630","article-title":"Umbilical cord characteristics and their association with adverse pregnancy\n                    outcomes: a systematic review and meta-analysis","volume":"15","author":"DJ L Hayes","year":"2020","journal-title":"PLoS One"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1055\/s-0039-1679866","article-title":"Electronic fetal monitoring and neonatal outcomes when a nuchal cord is present\n                    at delivery","volume":"37","author":"E B Carter","year":"2020","journal-title":"Am J Perinatol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1038\/s41372-019-0511-x","article-title":"The effect of nuchal cord on perinatal mortality and long-term offspring\n                    morbidity","volume":"40","author":"R Masad","year":"2020","journal-title":"J Perinatol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1097\/01.AOG.0000165322.42051.0f","article-title":"Nuchal cords in term and postterm deliveries\u2014do we need to know?","volume":"106","author":"L Sch\u00e4ffer","year":"2005","journal-title":"Obstet Gynecol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1007\/s00414-017-1746-8","article-title":"Umbilical cord entanglement's frequency and its impact on the newborn","volume":"132","author":"T Walla","year":"2018","journal-title":"Int J Legal Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1002\/uog.1874","article-title":"Is fetal cerebral vascular resistance affected by the presence of nuchal cord(s)\n                    in the third trimester of pregnancy?","volume":"25","author":"D M Sherer","year":"2005","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1046\/j.1469-0705.1998.12020125.x","article-title":"Sonographic demonstration of nuchal cord and abnormal umbilical artery waveform\n                    heralding fetal distress","volume":"12","author":"G Pilu","year":"1998","journal-title":"Ultrasound Obstet Gynecol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"6970","DOI":"10.3390\/jcm11236970","article-title":"Is there an added neonatal risk in vacuum-assisted deliveries with nuchal\n                    cord?","volume":"11","author":"H Schreiber","year":"2022","journal-title":"J Clin Med"},{"key":"ref26","first-page":"441","article-title":"Outcome of infants born with nuchal cords","volume":"34","author":"W F Miser","year":"1992","journal-title":"J Fam Pract"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.3390\/diagnostics15101197","article-title":"Perinatal outcomes related to the presence of a nuchal cord during delivery: a\n                    retrospective cohort study","volume":"15","author":"G V Silva","year":"2025","journal-title":"Diagnostics (Basel)"}],"container-title":["Zeitschrift f\u00fcr Geburtshilfe und Neonatologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2956-6022.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:28:37Z","timestamp":1790810917000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2956-6022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":26,"URL":"https:\/\/doi.org\/10.1055\/a-2956-6022","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0948-2393","1439-1651"],"issn-type":[{"value":"0948-2393","type":"print"},{"value":"1439-1651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,23]]}}}