The Presence of Nuchal Cord Does Not Hinder the Normal Progression of Labor

Background: Nuchal cord is a common occurrence at birth, and its relation to some perinatal outcomes has been reported. The objective of this study was to investigate whether the presence of nuchal cord affects the normal progression of labor. Methods: We retrospectively examined women who delivered their babies at our clinic. The inclusion criteria were ≥ 37 weeks of gestation, cephalic presentation and a singleton pregnancy. The rates of induction/augmentation of labor, cesarean section/vacuum extraction and prolonged labor and the durations of the first and second stages of labor were compared between women with and without a nuchal cord, separately among nulliparous and multiparous women. Results: We enrolled 2,277 nulliparous and 2,548 multiparous women. A single nuchal cord was found in 559 (24.5%) nulliparous and 616 (24.2%) multiparous women. Multiple nuchal cords were found in 99 (4.3%) nulliparous and 104 (4.1%) multiparous women. Among nulliparous women, the use of vacuum extraction was higher in women with multiple nuchal cords; no such difference was observed among multiparous women. The rate of induction/augmentation of labor was similar between women with and without a nuchal cord in both nulliparous and multiparous women. Among nulliparous women, the median duration of the first stage of labor was 558, 635 and 550 min (P = 0.211), and that of the second stage of labor was 55, 59 and 60 min (P = 0.183), with no nuchal cord, a single nuchal cord and multiple nuchal cords, respectively. Among multiparous women, the corresponding values were 260, 270 and 256 min (P = 0.313) for the first and 13, 13 and 12 min (P = 0.616) for the second stage. The rate of prolonged labor was similar between nulliparous and multiparous women, regardless of the nuchal cord state. Conclusion: A nuchal cord is not associated with labor induction, nor does it hinder the normal progression of labor. J Clin Gynecol Obstet. 2019;8(2):48-53 doi: https://doi.org/10.14740/jcgo549