Presentation
Routine Anomaly Scan at 20 weeks of gestation.
Patient Data
Single loop of cord seen completely encircling the neck on on color Doppler.
Case Discussion
The nuchal cord was suspected in the sagittal scan after seeing a hyperechoic dot in the nuchal area (Divot sign). Doppler interrogation confirmed the diagnosis of a single loop of cord completely encircling the neck 360 degrees. In the present case, the fetus had no features of umbilical cord compression, suggesting that it was not a tight loop of cord around the neck. However, there was an associated marginal insertion of the cord into the placenta.
Tight nuchal cords may obstruct blood flow in the umbilical vein, which is thin-walled. In contrast, pulsatile thick-walled umbilical arteries continue to pump out fetal blood, leading to hypovolemia 1.
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