ABSTRACT
The occurrence of a nuchal arm during vaginal breech delivery is a potentially traumatic
event associated with high perinatal morbidity and mortality. This problem usually
cannot be anticipated and must be overcome immediately on diagnosis during the second
stage of labor. The results of a retrospective analysis of radiologic studies of 115
cases of term singleton breech deliveries are presented here. A nuchal arm in the
first stage of labor was diagnosed infive cases, an incidence of 4.35%. Of four vaginal
breech deliveries, one case resulted in severe handicapping neonatal trauma. We suggest
that radiologic diagnosis of a nuchal arm in the first stage of labor should indicate
abdominal delivery.