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Umbilical Cord Knot and What Expectant Mothers Need to Know
22/04/2025
- What is an Umbilical Cord Knot?
An umbilical cord knot occurs when the umbilical cord forms an actual knot during pregnancy. This condition is relatively rare, with an incidence rate of approximately 1 in 100 pregnancies. The umbilical cord plays a vital role in the exchange of oxygen and nutrients from the mother to the fetus. Therefore, any abnormality involving the umbilical cord, including knotting, can significantly affect the health and development of the fetus.
Umbilical cord knots can be classified into two types: loose knots and tight knots. Loose knots generally do not pose significant risks, but if the knot tightens as the fetus grows or during labor, it may lead to fetal hypoxia due to inadequate oxygen and nutrient supply.
2. Causes and Risk Factors
Several factors increase the likelihood of an umbilical cord knot forming, including:
- Increased fetal movement: Fetuses that are more active, especially during the early stages of pregnancy, are at a higher risk.
- Long umbilical cord: A longer-than-average umbilical cord provides more space for fetal movement, increasing the chance of knot formation.
- Multiple pregnancies: In cases of multiple gestations, the umbilical cords may twist or move more, raising the risk of knotting.
- Small-for-gestational-age (SGA) fetus: Smaller fetuses have more room to move within the uterus, which increases the likelihood of the umbilical cord knotting.
- In vitro fertilization (IVF) pregnancies: IVF pregnancies are more likely to involve longer umbilical cords and a higher incidence of abnormalities.
- Risks to the Fetus
Umbilical cord knots can pose serious risks to the fetus, particularly if the knot tightens during labor:
- Reduced blood flow and oxygen supply: A tightened knot can lead to reduced blood and oxygen flow to the fetus, resulting in acute fetal distress.
- Increased risk of stillbirth: According to studies from the FMF, the risk of stillbirth in pregnancies with umbilical cord knots is five times higher than in normal pregnancies.
- Fetal distress during labor: Signs of fetal distress may manifest if the knot becomes more severe as labor progresses.
However, there is no recommendation to terminate the pregnancy early solely because of the detection of an umbilical cord knot.
- Monitoring and Management of Pregnancy with Umbilical Cord Knot
- Doppler ultrasound monitoring: Doppler ultrasound is used to assess blood flow in the umbilical cord and detect abnormalities early.
- Cardiotocography (CTG): CTG is used to monitor the fetal heart rate and detect signs of fetal hypoxia.
- Fetal movement monitoring: Expectant mothers should monitor the frequency and intensity of fetal movements daily. A decrease in fetal movements may indicate fetal distress.
- Management During Labor
During labor, if signs of fetal distress are detected, a cesarean section may be recommended to ensure the safety of both mother and baby. Continuous fetal heart rate monitoring will also be employed to provide real-time data on fetal well-being
6. Advice for Expectant Mothers with Umbilical Cord Knot
- Regular prenatal visits: Consistent prenatal check-ups are essential to monitor the umbilical cord knot and ensure early detection of any complications.
- Follow medical guidance: Adhere to the doctor’s recommendations, particularly regarding Doppler ultrasound and CTG monitoring.
- Monitor fetal movements: If you notice a reduction in fetal movements or any abnormality, seek immediate medical attention.
- Prepare mentally: Although umbilical cord knots increase risks, timely medical care and intervention can still result in a healthy pregnancy and delivery.
- Conclusion
While an umbilical cord knot increases the risks for the fetus, close monitoring and timely medical intervention can help ensure a safe pregnancy outcome. If you have concerns or questions, consult with an obstetric specialist for precise and accurate advice. It is crucial to maintain a positive mindset and work closely with your healthcare team to ensure a healthy and safe pregnancy.
Hanh Phuc International Hospital is a reputable medical institution specializing in Obstetrics, Gynecology, and Pediatrics. The hospital places significant emphasis on managing high-risk pregnancies, such as those involving umbilical cord knots, placenta previa, advanced maternal age, maternal comorbidities, abnormal fetal presentations, placental abruption, and morbidly adherent placenta, all of which can impact the health of both the mother and the baby. With an experienced medical team, state-of-the-art equipment, and internationally recognized care protocols, Hanh Phuc International Hospital is committed to providing expectant mothers with a safe and joyful pregnancy experience.
Expert Advisor for the Article: Dr. Hoang Ngoc Hai, Deputy Head of Obstetrics & Gynecology Department
Hanh Phuc International Hospital
18 Binh Duong Avenue, Thuan An City, Binh Duong Province
Hanh Phuc International Clinic – Estella
5th Floor – Estella Place, 88 Song Hanh, Thu Duc City, Ho Chi Minh City