Clinical Significance of True Umbilical Knots: A Population-Based Analysis

U, Airas; Heinonen, Seppo

doi:10.1055/s-2002-25311

Cited by 84 publications

(86 citation statements)

References 11 publications

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“…The correlation between the presence of a true cord knot and fetal outcome has been questioned by other authors [14,15] . In our case, the severe growth restriction did not induce any permanent injury on the neonate.…”

Section: Discussionmentioning

confidence: 98%

Multiple True Umbilical Knots: A Silent Risk for Intrauterine Growth Restriction with Anomalous Hemodynamic Pattern

Clerici

Koutras²,

Luzietti³

et al. 2007

Fetal Diagn Ther

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True knots of the umbilical cord can represent a serious complication for the fetus due to the possible alteration in the fetal circulation with consequent intrauterine growth restriction or fetal death. We report a case of 5 true umbilical cord knots associated with severe fetal growth restriction and an abnormal hemodynamic pattern. The Doppler examination showed a hemodynamic pattern characterized by an early alteration in the waveform profile in the fetal venous districts with normal impedance to flow values in both uterine and umbilical arteries. This normal profile of the umbilical arteries remained unchanged until the last stage of hemodynamic decompensation, while the profiles of the uterine arteries remained normal until delivery. This case report suggests that it is important to pay close attention to the evaluation of the fetal cord in situations in which the above described hemodynamic pattern is noted. Although the ultrasound diagnosis of true knots is extremely difficult, the presence of a true knot should always be suspected in the presence of an intrauterine growth restriction fetus when the venous district is altered before the fetal arterial districts after exclusion of other detectable reasons for growth restriction.

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Section: Discussionmentioning

confidence: 98%

Multiple True Umbilical Knots: A Silent Risk for Intrauterine Growth Restriction with Anomalous Hemodynamic Pattern

Clerici

Koutras²,

Luzietti³

et al. 2007

Fetal Diagn Ther

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“…False knots have no known clinical significance. True knots of the umbilical cord occur in approximately 1% (0.04 to 1%) of pregnancies, with the highest rate occurring in monoamnionic twins [4].…”

Section: Discussionmentioning

confidence: 99%

Perinatal Mortality and Umbilical Cord Parameters: Is there Any Association?

Soliriya¹,

Goyal²,

Kachhawaha³

2017

J Preg Child Health

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Introduction: Abnormal cord parameters associate with high rate of asphyxia during delivery, foetal anomalies, non-reassuring foetal status, respiratory distress, foetal growth restriction and delivery interventions.Objective: To study the correlation between umbilical cord parameters and perinatal mortality. Materials and methods:This was a prospective study carried out in the Umaid Hospital, Dr. S N Medical College, Jodhpur from March-2014 to November-2014. It included 500 cases admitted to labour room with period of gestation >37 weeks. Details of delivery of baby including mode of delivery, Apgar score, NICU admission and any congenital anomaly found in unbooked cases post-natally was noted down. Umbilical cord parameters were also noted and correlated with perinatal outcome using Fischer's exact test and Chi square test. Results:Out of 500 cases, the cord length was normal in 88.2% cases while it was short in 6.2% and long in 5.6% cases. True knots were associated with a higher mean cord length of 95.83 ± 24.99 cm. The difference of mean cord length between single loop and more than two loops was highly significant (p value<0.001). Cesarean section rate was found to be significantly different between one loop and more than two loops (p<0.001). Conclusion:The excessively long cords are associated with cord prolapse, true knot and poor fetal outcome and increased operative interference. Short cords are associated with failed progress, cord rupture and congenital malformations. Nuchal cords are responsible for threatening fetal well being along with other placental as well as intrapartum factors for poor fetal outcome parameters of umbilical cord were examined at the time of delivery and after delivery: presence of any loop around neck, trunk, shoulder, etc. cord loops tight or loose in LSCS cases, number of loops of cord and positions, knots of cord (true or false), length and diameter of umbilical cord. Amongst these, we have excluded hypo and hypercoiled cords as there is much fluctuation in the number of coils with passage of time, postnatally. Determination of length of umbilical cord was done after the delivery of fetus, cord was clamped at two places and cut in between. From the cut end up to fetal umbilicus and placental attachment umbilical cord, length was measured with flexible tape in cm and added. A data check sheet was maintained for each case till completion of delivery. The umbilical cord length measurements were categorized into short, when the measured length was <39 cm, normal, when the measurement was between 39 to 95 cm and long cord if the measurement was >95 cm [1,2]. Statistical analysis was performed using SPSS17.0 for windows. The sample size of the study was calculated as 400 taking the power as 90% and 20% dropout. Continuous data were analyzed by t-test and categorical data by using Chi-square test or Fisher exact test. J Preg Child Health, an open access journal

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“…Cependant, différents facteurs de risques indépendants du noeud au cordon ont été mis en évidence : âge élevé, multiparité, foetus de sexe masculin, hydramnios, cordon long (> 80 cm) et HTA chronique [3,6,7].…”

Section: Discussionunclassified