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2022, Number 6

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Rev Fac Med UNAM 2022; 65 (6)

True Knot as a Cause of Persistent Fetal Tachycardia. Case Report

Geraldo-Murillo JA, Pérez JC, Rivera RJA

Language: Spanish
References: 15
Page: 20-25
PDF size: 295.87 Kb.


ABSTRACT

Umbilical cord abnormalities are associated with adverse effects during pregnancy. The true umbilical cord knot is present in 0.3-2.1% of pregnancies and has been associated with fetal death. Risk factors include maternal age, high BMI, multiparity, hypertensive disorders, smoking, polyhydramnios, gestational diabetes, male sex of the fetus, and other malformations. Prenatal diagnosis of the true knot is rare and challenging. Most are diagnosed at birth and only 0.08% of true knots are diagnosed prenatally. Non-reassuring cardiotocography traces may be present, reflecting hypoxic or mechanical stress disrupting fetal oxygenation. The aim of this case report is to present a case of true umbilical cord knot presenting with persistent fetal tachycardia during labor, resolved by vaginal delivery


REFERENCES

  1. Hayes DJL, Warland J, Parast MM, et al. Umbilical cordcharacteristics and their association with adverse pregnancyoutcomes: A systematic review and meta-analysis.PLoS One. 2020;15(9):e0239630. Published 2020 Sep 24.doi:10.1371/journal.pone.0239630

  2. Weissmann-Brenner A, Meyer R, Domniz N, et al. Theperils of true knot of the umbilical cord: antepartum,intrapartum and postpartum complications and clinicalimplications. Arch Gynecol Obstet. 2022;305(3):573-579.doi:10.1007/s00404-021-06168-7

  3. Pasquale G, Pasquale O. Fatal True Umbilical Cord Knot: aCase Report. EuroMediterranean Biomed J. 2019;14(7):30-3. http://dx.doi.org/10.3269/1970-5492.2019.14.07.

  4. Carter EB, Chu CS, Thompson Z, Tuuli MG, MaconesGA, Cahill AG. True knot at the time of delivery: electronicfetal monitoring characteristics and neonatal outcomes.J Perinatol. 2018;38(12):1620-1624. doi:10.1038/s41372-018-0250-4

  5. Spellacy WN, Gravem H, Fisch RO. The umbilical cordcomplications of true knots, nuchal coils, and cords aroundthe body. American J Obstet Gynecol. 1966;94(8):1136-42.http://dx.doi.org/10.1016/0002-9378(66)90777-0.

  6. Linde LE, Rasmussen S, Kessler J, Ebbing C. Extremeumbilical cord lengths, cord knot and entanglement: Riskfactors and risk of adverse outcomes, a population-basedstudy. PLoS One. 2018;13(3):e0194814. Published 2018Mar 27. doi:10.1371/journal.pone.0194814

  7. Hershkovitz R, Siberstein T, Sheiner E, et al. Risk factorsassociated with true knots of the umbilical cord. EurJ ObstetGynecol Reprod Biol. 2001;98(1):36-9. http://dx.doi.org/0.1016/S0301-2115(01)00312-8.

  8. Räisänen S, Georgiadis L, Harju M, Keski-Nisula L, HeinonenS. True umbilical cord knot and obstetric outcome.Int J Gynaecol Obstet. 2013;122(1):18-21. doi:10.1016/j.ijgo.2013.02.012

  9. Miller DA, Miller LA. Electronic fetal heart rate monitoring:applying principles of patient safety. Am J Obstet Gynecol.2012;206(4):278-283. doi:10.1016/j.ajog.2011.08.016

  10. Arriaga-López A, Álvarez-Torres A, Leyva-Díaz A,Cuevas-Arellano GG, Chavira Anaya CF. Nudo verdaderode cordón umbilical, hallazgo incidental al nacimiento.Reporte de 4 casos en un hospital de tercer nivel.Rev. Fac. Med. 2022;65(4):30-37. doi:10.22201/fm.24484865e.2022.65.4.04

  11. Bohîltea RE, Turcan N, Cîrstoiu M. Prenatal ultrasounddiagnosis and pregnancy outcome of umbilical cord knot–debate regarding ethical aspects of a series of cases. JMedLife. 2016;9:297-301.

  12. Sherer DM, Amoabeng O, Dryer AM, Dalloul M. CurrentPerspectives of Prenatal Sonographic Diagnosis and ClinicalManagement Challenges of True Knot of the UmbilicalCord. Int J Womens Health. 2020;12:221-33. http://dx.doi.org/10.2147/IJWH.S192260.

  13. Weissmann-Brenner A, Domniz N, Weissbach T, et al. AntenatalDetection of True Knot in the Umbilical Cord - HowAccurate Can We Be?. Pränataler Nachweis eines echtenNabelschnurknotens – Wie treffsicher sind wir?. UltraschallMed. 2022;43(3):298-303. doi:10.1055/a-1205-0411

  14. Szczepanik ME, Wittich AC. True knot of the umbilicalcord: a report of 13 cases. Mil Med. 2007;172(8):892-894.doi:10.7205/milmed.172.8.892

  15. Méndez B, Cándido E. Nudos verdaderos del cordón Umbilical.Presentación de tres casos. Maternidad de Ouargla.2017-2018, Argelia. Multimed. 2021; 25(4): e2218.




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