Caesarean delivery of a breech singleton with eight loops of nuchal cord

Nuchal cord accidents comprise a third of stillbirths in the third trimester. These are often due to higher order nuchal cords, with more than three loops. In this report, we discuss a case of a gestation complicated by a nuchal cord with eight loops and severe fetal growth restriction, requiring expedited delivery due to non-reassuring fetal heart tones. Our case demonstrates the value of high-quality ultrasound in detecting complex nuchal cords, as well as highlighting the potentially dynamic and unstable fetal status in an affected gestation. Antenatal knowledge of nuchal cord in the setting of non-reassuring fetal status can help guide patient counselling and assist with identifying possible aetiologies. Finally, our case demonstrates that close monitoring and early intervention can prevent potentially catastrophic outcomes.