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Nuchal cord is not associated with adverse perinatal outcome

Abstract

Objective: The present study was aimed at evaluating the outcome of pregnancies with nuchal cord. Methods: A retrospective population-based study of all deliveries during the years 1988–2003 in a tertiary medical center was conducted. Immediate perinatal outcome of patients with and without nuchal cord was compared. Results: Of 166,318 deliveries during the study period, 14.7% had a nuchal cord, documented at birth (n=24,392). Higher rates of labor induction and non-reassuring fetal heart rate patterns were noted among pregnancies with nuchal cord as compared with the control group (30.1% vs. 24.2%; OR=1.3, 95% CI 1.3–1.4, P<0.001 and 4.5% vs. 2.6%; OR=1.8, 95% CI 1.6–1.9, P<0.001; respectively). The cesarean delivery rate was significantly lower among pregnancies with nuchal cord (11.5% vs. 12.7%; OR=0.9, 95% CI 0.8–0.9, P=0.001). Although 1 min Apgar scores lower than 7 were more common in pregnancies with nuchal cord (4.8% vs. 4.4%; OR=1.1, 95% CI 1.01–1.2, P=0.008), these pregnancies actually had lower rates of 5 min Apgar scores less than 7 (0.5% vs. 0.7%; OR=0.8, 95% CI 0.6–0.9, P=0.004). Likewise, the perinatal mortality rate was significantly lower in pregnancies with nuchal cord as compared with the comparison group (11/1,000 vs. 16/1,000; OR=0.7, 95% CI 0.6–0.8, P=0.001). Conclusions: Nuchal cord is not associated with adverse perinatal outcome. Thus, labor induction in such cases is probably unnecessary.

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Correspondence to Eyal Sheiner.

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Presented in part at the 15th World Congress on Ultrasound in Obstetrics and Gynecology 25–29 September 2005, Vancouver, Canada.

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Sheiner, E., Abramowicz, J.S., Levy, A. et al. Nuchal cord is not associated with adverse perinatal outcome. Arch Gynecol Obstet 274, 81 (2006). https://doi.org/10.1007/s00404-005-0110-2

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Keywords

  • Nuchal cord
  • Perinatal outcome
  • Apgar scores
  • Perinatal mortality