title: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel. sheiner@bgu.ac.il
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
authors.forename: Jacques S
authors.initials: JS
authors.lastname: Abramowicz
authors.forename: Amalia
authors.initials: A
authors.lastname: Levy
authors.forename: Tali
authors.initials: T
authors.lastname: Silberstein
authors.forename: Moshe
authors.initials: M
authors.lastname: Mazor
authors.forename: Reli
authors.initials: R
authors.lastname: Hershkovitz
mesh_terms: D001034:Apgar Score; D001724:Birth Weight; D002585:Cesarean Section; D005260:Female; D005865:Gestational Age; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007751:Labor, Induced / Q000706:statistics & numerical data; D008423:Maternal Age; D053589:Nuchal Cord / Q000150:complications*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies