True knot of the umbilical cord, intrapartum diagnosis and favorable outcome

Santos- Rosales Y.R.; Huamani-De la Cruz R.E.; Acuña-Montalvo M. · Revista Cubana de Medicina Militar (2026)

Resumen

Introduction: True umbilical cord knot is an uncommon anomaly with the potential to cause fetal hypoxia and adverse perinatal outcomes, particularly when tightened. Prenatal diagnosis remains limited, although advanced imaging techniques such as 4D ultrasound and Doppler improve detection. Nevertheless, most cases are identified at delivery. Objective: To describe a case of true umbilical cord knot diagnosed intrapartum with a favorable neonatal outcome, and to contextualize the finding through a review of the literature. Clinical Case: A 24-year-old woman, G3P2001, at 38 weeks and 5 days of gestation, was admitted in active labor. Meconium-stained amniotic fluid and early decelerations on fetal monitoring were observed. During spontaneous vaginal delivery, a loose true umbilical cord knot was identified, without complications. The newborn was male, with Apgar scores of 8 at 1 minute and 9 at 5 minutes and required no resuscitation. Conclusion: True umbilical cord knot should be considered in the presence of predisposing factors. Intrapartum detection and appropriate fetal monitoring may help prevent complications. Further studies are needed to determine its long-term impact on neonatal health.

Instituciones: Universidad Nacional Mayor de San Marcos