True Knot of the Umbilical Cord and its Implications in the Fetal Well-Being
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Abstract
The true knot of the umbilical cord is a pathology with a relatively low incidence. However, it is associated with the risk of loss of fetal well-being and in severe cases with perinatal death.
There are both maternal and fetal risk factors, with different associated perinatal outcomes. Prenatal diagnosis is a challenge for the attending physician and almost all cases are findings at birth once the cord has been observed. However, over time, ultrasound methods have been developed to search for it in cases where suspicion is high. and most cases are findings at birth, however, today ultrasound methods are available for their intentional search, mainly in patients with unidentified risk factors.
Similarly, it should be suspected in the presence of an altered cardiotocographic record or one that shows a non-reassuring pattern, especially when there is no response to established intrauterine resuscitation maneuvers, such as left lateral decubitus position, supplemental oxygen and maternal hydration.
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References
I. Szczepanik ME, Wittich AC. True Knot of the Umbilical Cord: report of 13 cases. Mil Med.
;172(8):892-4. https://doi.org/10.7205/MILMED.172.8.892.
II. Spellacy WN, Gravem H, Fisch RO. The umbilical cord complications of true knots, nuchal coils, and cords around the body. American J Obstet Gynecol. 1966;94(8):1136-42. http://dx.doi.org/10.1016/0002-9378(66)90777-0.
III. Castro T, Gomez-Suarez D. Diagnóstico prenatal de un nudo verdadero de cordón umbilical mediante 4D. Clin Invest Ginecol Obstet. 2007;34(5):208-10.
IV. Ramón y Cajal CL, Martínez RO. Prenatal diagnosis of true knot of the umbilical cord. Ultrasound Obstet Gynecol. 2004;23(1):99-100.
http://dx.doi.org/10.1002/uog.900.
V. Peesay M, Nuchal cord and its implications. Matern Health Neonatol Perinatol. 2017;3(1):1-11. http://dx.doi.org/10.1186/s40748-017-0068-7.
VI. Bernardete H, Niza D. Nudos verdaderos de cordón umbilical. Reporte de 4 casos. An Med (Mex). 2015;60(2):137-40.
VII. Guzikowski W, Kowalczyk D, Więcek J. Diagnosis of true umbilical cord knot. Arch Med Sci. 2014;10(1):91-5.
http://dx.doi.org/10.5114/aoms.2013.33068.
VIII. Olaya-Contreras M, Vargas-Moreno W, Bernal-Villegas JE. Una aproximación desde la física a las consecuencias patológicas de la longitud excesiva del cordón umbilical. Rev Colomb Obstet Ginecol. 2015;66(1):53. https://doi.org/10.18597/rcog.
IX. Srinivasan A, Graves L. Four true umbilical cord knots. J Obstet Gynaecol Can. 2006;28(1):32-5. https://doi.org/10.1016/S1701-2163(16)32053-9.
X. Clerici G, Koutras I, Lizietti R, Di Renzo GC. Multiple true umbilical knots: a silent risk for intrauterine growth restriction with anomalous hemodynamic pattern. Fetal Diagn Ther.
;22(6):440-3. http://dx.doi.org/10.1159/000106351.
XI. Chung Delgado K, Gil Oliden E. Desaceleración intraparto por nudo verdadero ajustado de cordón umbilical. RCCI. 2014;5(2):89-92.
XII. 12. Pasquale G, Pasquale O. Fatal True Umbilical Cord Knot: a Case Report. EuroMediterranean Biomed J. 2019;14(7):30-3.