True Knot of the Umbilical Cord and its Implications in the Fetal Well-Being

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