"true knot"

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How many times in how many years have you seen a baby with a "true knot" in its umbilical cord? Did it cause any complications during labor/delivery? Did the baby have any complications? Was the knot detected before delivery and if so did they do a c-section based on that alone?

Specializes in Maternal - Child Health.

I've known of 2. The first was my co-worker who suffered a full term fetal demise. The knot was found at delivery.

The second was a pre-term mom, about 30 weeks who complained to her OB that she wasn't feeling regular movement. He was convinced that she was just being a PIA, but sent her for monitoring, which revealed multiple prolonged decels below 60. No time for steriods, crash C-section and the sickest preemie I ever cared for who survived to discharge. Now close to graduating high school :)

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Just saw one the other day!! New to L&D (6 months) - no signs of complications before delivery, during delivery. No issues with babe. The OB didn't even notice - it was closer to the umbilicus when put the cord clamp on it then found it. The family all took photos...was very cool.

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One of my kids was born with two knots in his umbilical cord, one over the other, and he was perfectly healthy, with an apgar of 9. The doc said he had never, in 25 years, ever seen or heard of such a thing. He is my true miracle baby, and I wonder if my two and a 1/2 months on bedrest due to early contractions had anything to do with him being born healthy. He was really active during the pregnancy.

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I have seen several in the almost 8 yrs that I've worked OB, with varied results. Had one term delivery with a knot with no issues whatsoever. One 37 wk fetal demise with a knot and the cord around baby's neck. Another 39 wk demise with 3 knots in cord & cord was necrotic between 3rd knot & baby. I've also seen a 33wk IUGR baby with true knot-delivered by c/s for non-reassuring FHT that ended up ultimately doing well, although had to stay a few extra days. Probably my most memorable knot was a 37 weeker that came in with ROM early one evening. Baby's head stayed at -5 station all night. Had a few episodes of FHT dropping to 60s-70s and staying there for several (4-6) min through the night. Finally just after I gave report, FHT dropped to 60s & wouldn't come back up for over 10 min. We did everything, including knee-chest position & brethine, and finally c/s at which time they found the knot. I was not in OR for the c/s (I was trying to finish up so I could go home), but the dad showed me a pic of the knot that he had taken w/ his phone. Baby ended up doing pretty well-needed a little PPV, but 5 min apgar was like 8 or 9.

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Specializes in Labor and Delivery, Orthopedic.

I know this is an old thread but I just wanted to chime in. I just started on L&D (4 weeks in) and I just was in on my first C-section. There was a true knot plus a loose nuchal x1. Not known prior to delivery and mom/baby are fine. The cord was long - 80cm! So I'm sure that had something to do with it.

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Specializes in Nurse Leader specializing in Labor & Delivery.

I've seen it three times. All times, it was not detected until after delivery, and it did not cause any problems with labor or heart tones. Twice the woman had a lady partsl delivery, and once it was a scheduled C/S.

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Seen lots! My sister was a double nuchal cord with a true knot. The most memorable one for me was a booked section--there was a true knot but it was a figure 8 knot!! We took pictures. It was bizarre and lucky she didn't labour.

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Specializes in Labor and Delivery.

I have seen one so far. Everyone was so fascinated by it of course. It was a uneventful lady partsl delivery with no complications. Baby had a nice strip!!

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Where I work we would never wait 10 minutes to decide to roll back for a c/s with fhts in the 60's. then again, just the recurrent prolonged decels will buy you a section with most ob/gyns

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I was in a vag delivery with a nuchal and true knot x2. Baby was fine and really no indication on the efm. Really lucky mom and baby.

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Specializes in OB, OR.

Let's see...I've seen maybe 1/2 dozen or so in 3.5 years as a L&D nurse. Usually no complications at all and undetected until birth. Usually u see it and go, "oh...so that's why she kept having variables!"

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Specializes in Acute Rehab, OB, MedSurg.

I had a true knot with one of my own children, born in 2006. It was not previously detected and caused no complications. I had a vag delivery.

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