True knot of the umbilical cord in advanced weeks of pregnancy: a case report

Abstract

Abstract

Two knots in an umbilical cord with seventy centimeter length: A case report

“…In addition, even if it occurs, it is almost impossible for the embryo to survive without a developmental disruption or other disorders. 1,7 These true knots potentially prove fatal. More specifically, true knots can be loose and cause little disturbance to the blood supply to the fetus and only lead to SGA or IUGR, while tight true knots can cause abortion, IUFD intrapartum death, and stillbirth.…”

“…Although the root cause of formation of these true knots has not yet been elucidated thus far, some risk factors have been suggested in various studies including male gender, abnormally long umbilical cord, excess of amniotic fluid (polyhydramnios), small infant, monoamniotic fluid, increased fetal movement, multiparity, maternal gestational diabetes mellitus(due to the possibility of hydroamnios), amniocentesis (due to more accelerated contractions of the uterus resulting in increased fetal movements), and loose abdominal wall and uterine that are common in grand multipara women. [7][8][9][10][11] Thus far, no clinical tests or laboratory data have been reported in the literature for the definitive diagnosis of a problematic umbilical cord. However, Marco Scioscia et al suggested 4-dimensional and color Doppler sonography as a diagnostic modality in this regard.…”

“…With this in mind, the possibility of formation of two true knots in the birth cord is roughly zero. In addition, even if it occurs, it is almost impossible for the embryo to survive without a developmental disruption or other disorders 1,7 …”

“…Unfortunately, they cannot be diagnosed through screenings, and their antenatal identification is only accurate with color Doppler sonography of the umbilical artery, which is not routinely performed during pregnancies. Although the root cause of formation of these true knots has not yet been elucidated thus far, some risk factors have been suggested in various studies including male gender, abnormally long umbilical cord, excess of amniotic fluid (polyhydramnios), small infant, monoamniotic fluid, increased fetal movement, multiparity, maternal gestational diabetes mellitus(due to the possibility of hydroamnios), amniocentesis (due to more accelerated contractions of the uterus resulting in increased fetal movements), and loose abdominal wall and uterine that are common in grand multipara women 7‐11 . Thus far, no clinical tests or laboratory data have been reported in the literature for the definitive diagnosis of a problematic umbilical cord.…”

True umbilical cord knots are not always knotty: a case report

“…1 A long cord predisposes to a true umbilical cord knot (TUCK), which is an interweave of a segment of the umbilical cord, developing when a foetus slips through a loop in the cord. 1 True knots of the umbilical cord account for about 4% of all umbilical cord complications, affecting 0.3-1.3% of pregnancies. 2,3 Though the exact aetiology of formation of TUCK is unclear, risk factors, aside from a long umbilical cord, include polyhydramnios, maternal diabetes mellitus (DM), male foetus, small size foetus, advanced maternal age, chronic hypertension, anaemia, obesity, previous spontaneous abortion, multiparity, monoamniotic twin gestation, prolonged gestation, and amniocentesis.…”