Nuchal cord entanglement and outcome of labour induction

AIM OF THE STUDY: To assess whether nuchal cord entanglement would affect the outcome of elective labour induction. METHOD: 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. RESULTS: 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. CONCLUSIONS: 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.