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

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.