Effect of the Presence of Nuchal Cords on Vaginal Breech Labor

Objective: Breech delivery has been reported to be associated with a high incidence of abnormal fetal heart rate pattern leading to neonatal asphyxia. In this study, we examined the effect of the presence of nuchal cords on perinatal outcomes of vaginal breech labor. Methods: We reviewed the obstetric records of all singleton breech labor cases at the Japanese Red Cross Katsushika Maternity Hospital between 1999 and 2011. Of the 266 breech labor cases in singleton pregnancies, the presence of nuchal cords was recognized in 50 cases (18.8%) on neonatal findings at birth. We compared the clinical characteristics and perinatal outcomes between the breech labor cases with and without nuchal cords. A chi-square test was used for categorical data, and a p-value <0.05 was considered significant. Results: It was found that the incidence of fetal heart rate abnormality during breech labor or neonatal asphyxia in the deliveries with nuchal cords was not significantly different from that in those without nuchal cords. Also, there was no significant difference in the rate of emergent caesarean delivery between the two labors with and without nuchal cords. Conclusion: The current results suggest that the presence of nuchal cords may not be associated with perinatal outcomes. Our results may become one of several pieces of evidence leading to the alleviation of anxiety in pregnant women with breech presentation and fetal nuchal cords.