Electronic Fetal Monitoring and Neonatal Outcomes when a Nuchal Cord Is Present at Delivery

Am J Perinatol. 2020 Mar;37(4):378-383. doi: 10.1055/s-0039-1679866. Epub 2019 Feb 28.

Abstract

Objective: This study aimed to determine the association between nuchal cord, electronic fetal monitoring parameters, and adverse neonatal outcomes.

Study design: This was a prospective cohort study of 8,580 singleton pregnancies. Electronic fetal monitoring was interpreted, and patients with a nuchal cord at delivery were compared with those without. The primary outcome was a composite neonatal morbidity index. Logistic regression was used to adjust for confounders.

Result: Of 8,580 patients, 2,071 (24.14%) had a nuchal cord. There was no difference in the risk of neonatal composite morbidity in patients with or without a nuchal cord (8.69 vs. 8.86%; p = 0.81). Nuchal cord was associated with category II fetal heart tracing and operative vaginal delivery (OVD) (6.4 vs. 4.3%; p < 0.01).

Conclusion: Nuchal cord is associated with category II electronic fetal monitoring parameters, which may drive increased rates of OVD. However, there is no significant association with neonatal morbidity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cardiotocography*
  • Delivery, Obstetric
  • Female
  • Heart Rate, Fetal*
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / etiology
  • Maternal Age
  • Nuchal Cord* / complications
  • Nuchal Cord* / physiopathology
  • Pregnancy
  • Pregnancy Complications
  • Pregnancy Outcome
  • Prospective Studies
  • Young Adult