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EDUCATIONAL. A frightening case of an urgent life-saving cesarean section due to nuchal cord. The baby was cyanotic but survived after the cord has been unwrapped immediately after delivery. A nuchal cord occurs when the umbilical cord becomes wrapped around the fetal neck 360 degrees. Up to half of nuchal cords resolve before delivery, yet complicated cases pose a significant risk for lowered blood flow, hypoxia (low oxygen levels), and delivery complications.Management of a presenting nuchal cord should be tailored to prevent umbilical cord compression whenever possible. Techniques to preserve an intact nuchal cord depend on how tightly the cord is wrapped around the infant’s neck. If the cord is loose, it can easily be slipped over the infant’s head. The infant can be delivered normally and placed on maternal abdomen as desired. If the cord is too tight to go over the infant’s head, the provider may be able to slip it over the infant’s shoulders and deliver the body through the cord. The cord can then be unwrapped from around the baby after birth. Finally, if the cord is too tight to slip back over the shoulders, one may use the somersault maneuver to allow the body to be delivered. The birth attendant may also choose to clamp and cut the umbilical cord to allow for vaginal delivery if other methods of nuchal cord management are not feasible.