Objectives: To study the cord blood nucleated red blood cell count (NRBC) in asphyxiated and non asphyxiated fetuses at birth and to find out the correlation between NRBC count, fetal acidosis and various clinical markers of asphyxia.

Material and methods: A prospective, comparative case–control study was undertaken in a tertiary care hospital from January 2008  to November 2009, which included a total of 200 neonates with 100 asphyxiated babies (case group) and 100 normal babies (control group). Parturient women in labor between 37–40 weeks of gestation were selected after satisfying inclusion and exclusion criteria and then divided in 2 groups. The cord blood was collected immediately after delivery for measurement of NRBC/100 WBC, and pH.  Statistical analysis was performed with chi–square, Mannwhitney U–test and student t–test.

Results: The mean NRBC count was higher (23.3 +10.1) in cases than in controls, 12.5 +4.7 (p <0.05) The NRBC count was significantly higher in MSAF, in fetuses with non–reassuring fetal heart pattern and those with apgar score < 6 at 5 minutes (p <0.05).

Conclusion: NRBC counts of the cord blood can be used as an effective tool to confirm perinatal asphyxia. It is a simple, quick, accurate and clinically effective test to diagnose and initiate treatment to prevent long term sequel of perinatal asphyxia.