Accidental Finding of a True Umbilical Cord Knot
Bindu Deopa, Arjun Rawal, Aparajita Rawal, Anushree Pal
Abstract
A true umbilical cord knot is mostly an incidental finding at birth despite having antenatal diagnostic modalities such as 3-dimensional ultrasonography or Doppler studies. Polyhydramnios, small-size fetus, male fetus, a long umbilical cord, and multiparity are some of the factors that contribute to the formation of a true umbilical cord knot. The outcomes vary from a healthy neonate to fetal loss.
In this case series, we describe the cases of 2 neonates with a true umbilical cord knot, who were delivered on the same day. The first neonate was delivered by a 29-year-old primigravida through lower segment cesarean section (LSCS) because of decreased fetal movements. Her antenatal scan done at 37 weeks of gestation was normal. The neonate cried immediately after birth and had an Apgar score of 8 at 1 minute and 9 at 5 minutes.
The second neonate was delivered by a 31-year-old woman (G2P1A0L1). LSCS was done because of decreased fetal movements. Her antenatal scans at 32 and 36 weeks of gestation were normal. The neonate did not cry immediately after birth and, hence, required a bag and mask ventilation for 30 seconds. The neonate had Apgar scores of 6 and 8 at 1 minute and 5 minutes, respectively.
In both the cases, the umbilical cord knot was discovered at birth. Thus, it was deduced that true umbilical cord knots may have different outcomes in neonates. Early and prompt actions are required for quick recovery of neonates at birth.
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