Skip to content
Research Article Open access CC BY 3.0

True Knot of Umbilical Cord: A Diagnosis and Prognostic Challenge

Thaís Kappel Vieira Dal Pai, Camila Pauluci Arcolini, Amanda Muriela Gobatto, Anna Manoela de Holleben Bicca, André Campos da Cunha, Vinicius Freitas de Mattos, Patrícia Trevisan, Paulo Ricardo Gazzola Zen, Rafael Fabiano Machado Rosa

Journal of Advances in Medicine and Medical Research · pp. 5043–5052 · Published 9 Jul 2014

10.9734/BJMMR/2014/11536

Abstract

Introduction: True knot of the umbilical cord is characterized by a cord loop with increased tension and hence higher risk for obstetric and neonatal outcome intervention. It is a finding observed in 1-2% of births. Aim: Review the etiology, pathophysiology, diagnosis and prognosis of true knot of the umbilical cord. Methodology: We carried out a review searching for scientific articles present in the electronic database PubMed, using the descriptors “true knot“, “umbilical cord”, “Doppler sonography” and “prenatal diagnosis”. Articles published until 2013 were included in the review. Discussion: True knot of the umbilical cord is a relatively common finding at birth. However, its diagnosis in uterus is still quite rare. Several factors have been related to its etiology, including the size of the umbilical cord. Its appearance occurs mostly between 9 and 28 weeks of gestation, in the fetal period of greater mobility. The major part of the true knot of the umbilical cord is not associated to increased risk of obstetric intervention and neonatal outcomes because most are loose. However, true knots can tighten during pregnancy due to fetal movement or during labour, leading to reduced blood flow and consequent fetal asphyxia and death. Thus, the close monitoring of pregnancy in cases of true knot of umbilical cord is required. Prenatal diagnosis of true knot of the umbilical cord can be a challenge. Ultrasound complementary techniques, including color Doppler and Doppler velocimetry can improve the detection rate and help to differentiate true from false knots. And this has important implications for the management and prognosis of pregnancy, and consequences for the fetus and newborn.

Umbilical Cord; Fetus Ultrasound Prenatal Prenatal Care Prognosis

References (33)

  1. 1 The umbilical cord complications of true knots, nuchal coils, and cords around the body [DOI]
  2. 2 Risk factors associated with true knots of the umbilical cord [DOI]
  3. 3 Cord entanglement and perinatal outcome in monoamniotic twin pregnancies [DOI]
  4. 4 Clinical Significance of True Umbilical Knots: A Population-Based Analysis [DOI]
  5. 5 The Umbilical Cord: Obstetrically Important Lesions [DOI]
  6. 6 Cord entanglement in monoamniotic twins: does it really matter? [DOI]
  7. 7 Dictionaire des sciences médicales
  8. 8 Umbilical cord length and intrapartum complications.
  9. 9 Umbilical cord knots [DOI]
  10. 10 True knot of the umbilical cord: a difficult prenatal ultrasonographic diagnosis [DOI]
  11. 11 A comparison of umbilical cord blood gas values between newborns with and without true knots [DOI]
  12. 12 Length of the Human Umbilical Cord at Term [DOI]
  13. 13 Predisposing factors in the formation of true knots of the umbilical cord-analysis of morphometric and perinatal data [DOI]
  14. 14 Prenatal diagnosis of true knot of the umbilical cord [DOI]
  15. 15 Die Blutgefässe der menschlichen Nachgeburt in normalen und abnormen Verhältnissen
  16. 16 The Length of the Human Umbilical Cord [DOI]
  17. 17 True knot of the umbilical cord [DOI]
  18. 18 Maligned umbilical cord entanglements [DOI]
  19. 19 Three-Dimensional Power Doppler Sonography in the Prenatal Diagnosis of a True Knot of the Umbilical Cord [DOI]
  20. 20 Multiple True Umbilical Knots: A Silent Risk for Intrauterine Growth Restriction with Anomalous Hemodynamic Pattern [DOI]
  21. 21 Four‐dimensional and Doppler sonography in the diagnosis and surveillance of a true cord knot [DOI]
  22. 22 A review of the pathologic anatomy of the human placenta [DOI]
  23. 23 On the Abnormalities of the Umbilical Cord which may cause Antenatal Death. [DOI]
  24. 24 Prenatal observation of umbilical cord abnormalities: A triple knot and torsion of the umbilical cord [DOI]
  25. 25 Cord entanglement of monochorionic diamniotic twins following spontaneous antepartum septostomy sonographically simulating a true knot of the umbilical cord [DOI]
  26. 26 Prenatal Ultrasonographic Diagnosis of Conditions Associated with Potential Umbilical Cord Compression [DOI]
  27. 27 First report: Prenatal diagnosis of a true knot [DOI]
  28. 28 ANATOMY, ANOMALIES, AND PROLAPSE OF THE UMBILICAL CORD [DOI]
  29. 29 Congenital and acquired lesions of the umbilical cord and spontaneous abortion [DOI]
  30. 30 A study of umbilical cord encirclement [DOI]
  31. 31 Fetal and Funicular Vascular Anomalies [DOI]
  32. 32 Antenatal True Umbilical Cord Knot Leading to Fetal Demise [DOI]
  33. 33 Fetal Supraventricular Tachycardia Associated with a True Knot of Umbilical Cord [DOI]

Cited by 3

Umbilical Cord Abnormalities and Pregnancy Outcome

Waleed Elsayed, Anita Sinha · Journal of Fetal Medicine · 2019

Showing 1 of 3 known citations — external sources report more than can currently be individually listed.

Related research

Article metrics

Real usage data collected on this platform.

55

Page views

0

PDF downloads

30

Outbound clicks

3

Citations

Views over time

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

Traffic sources

Referring site, by host.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.