The umbilical cord plays an essential role in intrauterine life. It is the pathway between mother, placenta and fetus during pregnancy and delivery. Complete cord occlusion often leads to fetal demise, while intermittent occlusion has been associated with intrauterine brain damage. Compression and vasospasm in utero are important factors in fetal distress. Nuchal Umbilical Cord can be diagnosed antepartum using ultrasound, but the complications are unpredictable and unpreventable

Inclusion Criteria:

• Singleton pregnancy.
• Pregnant ≥ 37 weeks gestation.
• Women who will accept to participate in the study

Exclusion Criteria:

• Preterm deliveries.
• Amniotic fluid abnormalities (oligohydramnios, polyhydramnios).
• Intrauterine growth retardation
• Early membrane rupture
• Women need urgent cesarean section.
• Multifetal gestation.
• Placenta previa.
• Fetuses with major congenital anomalies.
• Women with chronic maternal illness as hypertension

Patients who are in labor will be followed up through regular fetal heart rate monitoring and clinically using partograph to monitor the progress of labor. Fetal heart rate changes and cases with abnormal progress of labor will be recorded. Mode of delivery either vaginal or cesarean will be noted. Those who are scheduled for elective CS will be evaluated during and after cesarean section.