Nuchal cord entanglement and outcome of labour induction

To assess whether nuchal cord entanglement would affect the outcome of elective labour induction.

In a group of pregnant women, the outcome of elective labour induction was evaluated in relation to a list of possibly related variables, including the presence of nuchal cord at delivery.

Overall 184 women submitted to induction of labour were prospectively examined. Vaginal delivery was observed in 141 women (76.6%), with 105 of them (or 57%) having been delivered within 24 h from induction. At delivery, nuchal cord was detected in 59 out of 184 neonates (32%). Among the pre-induction and post-induction variables, only parity ≥ 1 (OR 3.44; 95% CI: 1.67-7.06) and a Bishop score ≥ 5 (OR 3.59; 95% CI: 1.93-6.70) appeared statistically associated with the success of induction. The chance of vaginal delivery within 24 hours from labour induction (31/59 or 53% vs 74/125 or 59%; OR: 0.92; 95% CI: 0.75-1.12) were comparable among the neonates with and without nuchal cord at birth.

In women undergoing cervical ripening, multiparity and a favourable cervical score seem the only factors that predict a successful induction. An entangled cord around the fetal neck does not seem to increase the risk of induction failure.