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

Ebony B. Carter, Cheryl S. Chu, Zach Thompson, Methodius G. Tuuli, George A. Macones, Alison G. Cahill

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


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.

Original languageEnglish
Pages (from-to)378-383
Number of pages6
JournalAmerican journal of perinatology
Issue number4
StatePublished - Mar 1 2020


  • electronic fetal monitoring
  • fetal heart rate
  • neonatal morbidity
  • nuchal cord


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