True knot of the umbilical cord: essence, causes of formation, consequences and diagnosis. True and false knots of the umbilical cord

After the release of the congratulatory article for February (Congratulations for sisters who gave birth in February), “pregnancy fears” of obstetric pathologies, including such as “true knot on the umbilical cord,” began to surface in the prenatal group and in the comments.

I want to make a reservation right away that you will never foresee all obstetric pathologies, neither in the hospital nor at home. But, giving birth at home-solo, that is, focusing not on CTG sensors, ultrasound or someone else's experience, but on your maternal intuition, on your experience that you have gained during the preparation and having a clear conviction in the correctness of your actions, you can feel when you really need help, despite the fact that outwardly everything is fine, and when you don’t need it, although there are some signs that official medicine regards as pathologies.

What is a true knot?

True knot on the umbilical cord

“A true umbilical cord knot is a true knot in the umbilical cord, presumably occurring in the very early stages of pregnancy, when the baby is very small and actively moving. In rare cases, the umbilical cord may fail to form a loop, and the child slips through it, resulting in a knot. The long umbilical cord increases the risk of true knot formation.

The appearance of a true node may not be reflected in the course of pregnancy and childbirth. In some cases, the tightening of the true knot of the umbilical cord causes sudden intrauterine death of the fetus at different stages of pregnancy.

The main danger of such a node is during childbirth, when there is a high risk that it can drag on and block the supply of oxygen to the baby before birth. At the same time, a long umbilical cord, which increases the risk of knot formation, reduces its danger in childbirth.

How to diagnose it?

Question: Hello! On March 6, at the 40th week of pregnancy, CTG was performed, according to the doctor, everything was “just fine”. On March 7, the heartbeat was no longer audible, she gave birth to a dead child. The reason is the true knot of the umbilical cord. The doctors said that there were no harbingers of such a development of events. According to the pathoanatomical conclusion, the child was healthy. How can you see the umbilical cord knot (and is it possible at all)? Doppler was carried out for a period of 20 weeks, showed the norm.

Answer of the obstetrician-gynecologist: Hello, Sophia!
This, unfortunately, sometimes happens. And if the node is not tightened and / or the vessels in this place are not thrombosed, it is, alas, impossible to suspect the node. If the knot is tightened, pronounced changes immediately appear on the CTG and when listening with a tube. That is, the node manifests itself exclusively as a difficulty in blood flow and acute hypoxia. This is an infrequent pathology, but very insidious.
From the good we can say that since the cause of the true knot is pure chance, therefore, the frequency is low and what happened does not burden the prognosis of a subsequent pregnancy. Which is what I wish you.
Rather, “lick your wounds” and give birth to a healthy baby in two years.
Good luck to you!

Is it more dangerous to give birth to a child with a true knot at home than in the Maternity Hospital?

Probably many people have asked this question.

We repeat once again that its diagnosis is very difficult, it is rarely detected, since it is delayed, as a rule, already in the birth itself. But the harm of ultrasound, CTG (Safe Ultrasound), is quite real, that is, trying to find this rather rare and difficult to diagnose pathology, you can harm a huge number of children.

That is, those who are afraid of the true knot, as well as umbilical cord prolapse, and other unpredictable obstetric pathologies, are better prepared for the birth of a child in a hospital. Not because they can help, but because you can “put the blame” on them, etc.

In fact, intuitive childbirth often becomes the cause of salvation for babies, everyone knows that you need to breathe while trying, and so on, or how to push or not push on command in a maternity hospital, and in intuitive childbirth, a woman’s body can save a child, roll with a wave of “animal attempts ”, when the child, tearing tissue, literally flies out of the mother’s body (which is impossible in the maternity hospital, where there is epidural anesthesia, “gas” and other medical pain relief).

So everyone has their own reasons. For some, it’s easier to trust the sensors, and for someone to listen to your body and intuition.

But how do they solve the problem of a true knot in the Maternity Hospital?

The answer is simple - NO. Often it is only ascertained upon the fact of birth, either the child was born alive with a true knot (and this is no longer fixed, due to the lack of need), or stillbirth (and as the cause of death they put “a true knot on the umbilical cord”, although in fact the reasons could be other).

As we wrote in the article "Briefly about home birth":

“Childbirth is both life and death, and pain, and happiness, and flight, and falling into the abyss. There can be EVERYTHING, but this EVERYTHING depends on the qadar of Allah, but the reasons are attitude and preparation, that is, life as close as possible to the Sunnah.

Only in a Maternity hospital of a standard type, a woman does not have the opportunity to get closer to nature, since her maternal instinct is turned off there, and doctors have all the power, and in fact they give birth for a woman, and not she gives birth to her child, but if a tragedy happens, then they wash their hands. But to be objective, let's clarify that there are unpredictable obstetric pathologies, and there are pathologies caused by doctors, but in both cases no one will be responsible for your fate and your trials.

If you search www.google.com for "true umbilical cord knot", the entire page will be filled with links like this:

True umbilical cord knot "I decided to come back here ... first I left .... I don't have a daughter ...."

True knot of the umbilical cord (Pregnant and faint of heart do not read)….

True knot of the umbilical cord

» Hello! On March 6, at the 40th week of pregnancy, CTG was performed, according to the doctor, everything was “just fine”. On March 7, the heartbeat was no longer audible, she gave birth to a dead child ... "

It is very interesting to read the comments, both of the women themselves, who were "honest" patients, and of the doctors. But childbirth is not a well-learned lesson, where you will be given an A, if you do everything as “necessary”, this is the fate of both you and this child, and if for many the true knot did not cause death, but for someone it did, then this is their fate, so Allah predetermined, and if this reason were not there, it would be different. Your weapon is dua (prayer), purification of the soul and heart, sadaka.

Statistics:

In a sample of more than 400 births, I, as a Daola, had two cases of a successful birth with a true knot on the umbilical cord, and we know one tragic case (in a family from the North Caucasus) of the birth of a dead child with a true knot (inna li Llahi wa inna ileihi rrajiun). These are our little statistics.

Here's what the official data says:

“A true umbilical cord knot, fortunately, is extremely rare. According to statistics, it occurs only in about 1-2% of pregnancies. And although the true umbilical cord knot itself poses a certain risk for the child, according to many experts, it becomes quite rare as a cause of intrauterine death, despite the statistics that call the figure 6%, which in itself is quite a lot. Obstetricians explain their position by the fact that data on the frequency of births with a true umbilical cord node are greatly underestimated, because maternity hospitals do not display information about umbilical cord nodes in statistics if they did not affect the outcome and course of childbirth.

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Among the various pathologies associated with the presence of umbilical cord defects, there are quite dangerous ones. The true knot of the umbilical cord is one of such insidious pathologies. This article will talk about what a true umbilical cord knot is, why it is dangerous for a child.

What does this mean?

Normally, the umbilical cord or umbilical cord is an elongated "cord". It stretches from the baby to the placenta. The umbilical cord can be considered a kind of "bridge", which during pregnancy connects an actively developing baby with his mother.

The umbilical cord is quite long. In a normal pregnancy, the length of a healthy umbilical cord is 50-70 cm. The thickness of the umbilical cord is usually about 2 cm. This rather large length contributes to the fact that the umbilical cord can twist into loops or even knots. Doctors call such nodules true.

It should be noted that This pathology is quite rare in obstetric practice. Based on statistics, it can be noted that true nodes on the umbilical cord appear in about 1% of all cases. However, this pathological condition is extremely dangerous. It can significantly aggravate the course of pregnancy and even contribute to the development of dangerous pathologies in the fetus.

Reasons for education

A variety of factors can lead to the appearance of nodules on the umbilical cord. The most common cause of the development of this pathology is the intensive physical activity of the baby. Usually, the fetus that develops in the mother's womb is more mobile in the first half of pregnancy. The smaller the child, the easier it is for him to move.

As the baby grows, the number of active movements he makes begins to gradually decrease. This is because the baby gradually becomes crowded in the uterus. This feature is responsible for the fact that true nodules on the umbilical cord are formed mainly before the 3rd trimester of pregnancy. This fact is confirmed by the reviews of mothers who encountered this problem while carrying babies.

Diagnostics

It should be noted right away that the determination of true nodules on the umbilical cord is a rather difficult task. Usually, such changes are detected by doctors already retrospectively - after the birth of the child. After the birth of the placenta and umbilical cord, doctors may carefully examine them. With such an examination, as a rule, true nodules are detected.

Unfortunately, it is impossible to suspect the presence of a pathology only by some clinical signs or symptoms. There are no specific signs that would absolutely indicate the presence of nodules on the umbilical cord.

It is worth noting that sometimes nodules on the umbilical cord are still detected during ultrasound. This usually becomes possible when the study is carried out on expert-level devices, by an experienced and qualified specialist. The difficulty in detecting true nodules on the umbilical cord is that the umbilical cord is quite long. An ultrasound specialist cannot always examine every centimeter of it.

It is possible to suspect the presence of a node on the umbilical cord through dopplerography. This method allows you to evaluate the blood flow in the umbilical vessels. A decrease in the speed of blood flow in certain areas of the umbilical cord is one of the signs that may indicate the presence of a node.

If, during pregnancy, nodes on the umbilical cord were found in the future mother with ultrasound, then in the future, she is carefully monitored by a doctor. In the time remaining before delivery, doctors must assess the condition of the fetus. For this, cardiotocography is often used. Through this diagnostic test, you can determine the heart rate of the baby, as well as evaluate his physical activity.

The future mother herself can also control the activity of the baby. In the second half of pregnancy, she, as a rule, already feels the baby quite well in her stomach.

If a pregnant woman notes that her child has drastically changed her motor activity, then she should definitely notify her obstetrician-gynecologist about this.

Consequences for the child

It is impossible to imagine the full development of a baby without an umbilical cord. With the help of this unique organ, which appears in the female body only during pregnancy, the fetus receives all the nutrients necessary for its growth. A baby in the womb cannot feed on its own. He receives all the necessary proteins, fats and carbohydrates through the blood from his mother. At the same time, nutrients enter through the blood vessels that are located directly inside the umbilical cord.

Through the umbilical vessels, the baby receives oxygen dissolved in the blood. During intrauterine life, the baby's lungs do not function. The respiratory system will fully work only after the baby is born and takes its first breath in life. Up to this point, the baby receives dissolved oxygen through the system of umbilical vessels - from his mother.

The umbilical cord plays another important role: it is involved in the disposal of metabolites. Through the system of umbilical vessels, the fetus "gets rid" of waste chemicals that are unnecessary to its body. Ensuring the functions of the umbilical cord is possible if during pregnancy any anomalies or defects do not develop in the umbilical cord. The presence of nodes contributes to the fact that the blood vessels in the umbilical cord are pinched. In this case, the blood supply to the baby and the placenta is disturbed.

Insufficient supply of oxygen to the blood contributes to the fact that the baby develops an extremely dangerous condition - intrauterine hypoxia. It is dangerous because the blood supply to the internal organs of the child is greatly reduced. This leads to disruption of their functioning.

Persistent intrauterine hypoxia is also dangerous because the baby may develop a violation of cardiac activity. This situation is extremely dangerous and requires urgent intervention by doctors to save the life of the fetus.

In some cases, it is possible to determine the consequences of prolonged intrauterine hypoxia in a baby only after his birth. Babies who have encountered this pathology during their fetal development may have a lower birth weight, low immunity levels, as well as a number of concomitant congenital diseases. In some cases, persistent intrauterine hypoxia can contribute to the formation of a number of pathologies of the nervous system.

Another possible complication that can develop in the presence of true nodes on the umbilical cord is thrombosis of the umbilical cord. In the clamped section of the umbilical cord, blood flow is significantly reduced. Slowing the flow of blood causes the platelets (platelets) to stick together more quickly, leading to the formation of blood clots.

Through a thrombosed umbilical cord, a full blood flow is impossible. In such a situation, the child's body does not receive enough nutrients and oxygen. The stronger the lumen of the blood vessels of the umbilical cord is closed, the more unfavorable the prognosis of the further course of pregnancy. Unfortunately, in such a situation, there is a high risk of abortion (and even stillbirth).

If the nodules on the umbilical cord appeared closer to the birth, then in this case the possibility of self-"unraveling" is rather low. However, even in this situation, a child can be born into the world absolutely healthy. The presence of multiple nodules on the umbilical cord and related indications may lead doctors to resort to performing a caesarean section.

Obstetrician-gynecologists usually choose a surgical method of childbirth if the course of pregnancy is complicated by a number of certain conditions. A caesarean section is performed if the presentation is abnormal (or if the fetus is too large). The large size of the baby with a narrow pelvis of the mother is also an indication for a caesarean section. In this case, independent childbirth can be very dangerous.

During passage through the birth canal, the child may become entangled in the umbilical cord or squeeze it strongly. In this case, there is a sudden cessation of blood flow through the umbilical vessels, which can lead to various dangerous conditions, including a threat to life for the fetus. To avoid such dangerous complications, doctors resort to performing a caesarean section.

The choice of obstetric tactics for pregnant women with true nodes on the umbilical cord is carried out individually. To do this, doctors take into account all the factors that affect the course of pregnancy.

For information on how the blood circulation of the fetus during pregnancy, see the following video.

Yesterday I was at the third ultrasound screening in the LCD for m/f.
As always, visualization is difficult, everything is fuzzy, we watched for more than an hour, rotated in all directions.
They issued a conclusion: The size of the fetus corresponds to 34 weeks of pregnancy. Head presentation. IR: in the right uterine artery 0.37; in the left uterine artery 0.35; in the arteries of the umbilical cord, the fluctuation is from 0.44 to 0.6. In front of the anterior abdominal wall of the fetus, an accumulation of umbilical cord loops is determined, not excluded. the presence of a true knot of the umbilical cord. Consultation in KRD is recommended.
This morning we rushed to the expert ultrasound and DG to the clinical maternity hospital.
Ultrasound conclusion: The fetus corresponds to 33-34 weeks of pregnancy, the weight of the fetus is 2200 g, cephalic presentation. Premature maturation of the placenta.
Double entanglement of the umbilical cord around the neck of the fetus (not tight), a true knot of the umbilical cord.
Protocol UDS uterus and fetus: Indicators of uteroplacental and fetal-placental blood flow within normal limits.
I was terribly upset ... Eh-h-h, so everything began nicely and developed seamlessly, and on you! Get, fascist, a grenade!
They went to "their" doctor with all the results, did a CTG, no signs of "fetal suffering" were found. We agreed that I would come to the CTG and DG every week, if everything is still fine there, then I go to the PKS on 03/19/2018.
My husband ran away to worry about work, the elders are still at school, and I drink soothing tea, read the features and tune in to a caesarean section.
They say you have to try everything in life! I had terrible natural births, then wonderful ones, and now there will be a CS.
Everything will be fine!
You must, simply, believe in what is destined by fate, and not be afraid of the truth! (With)

My first impulse was the same, but → My first impulse was the same, but the doctor reassured me that there were no indications for an emergency CS, loops and knots were tightened only during childbirth, so it’s better to bring it under supervision until 37-38 weeks. Feb 20, 2018 12:43:12 pm

Nothing more and meet the baby :) 20.02.2018 13:00:15 Flamingo

Baby's heartbeat with a stethophonendoscope → I can listen to the baby’s heartbeats with a stethophonendoscope, but I myself refused a portable CTG, anyway, I don’t know how to decipher these curves. 02/20/2018 02:43:03 PM, SunReg

In the first birth, I also had 2 or → In the first birth, I also had a 2 or 3-fold entanglement, cat. then they didn’t see it on ultrasound, as a result, obstetric forceps were used in EP (I still remember with horror + consequences up to 3 years). why am I writing: if I had known then, I would have laid down on a Cesarean without hesitation, they saw you on time, that's good) the main thing is that everything was ok with the baby)) 20.02.2018 12:57:22, marmiwka

Still, progress is power. Everything is better → Still, progress is power. It is better to know everything and mentally prepare. And we will keep our fingers crossed that everything goes well. 02/20/2018 02:32:23 PM, Tatyana_Sh

I perfectly understand your fear and → I perfectly understand your fear and concerns. She herself was horrified when she had a triple in her first pregnancy! entanglement. I am a perinatal psychologist and in this I was probably more fortunate :) I got nervous, then I pulled myself together and tried to arrange therapy sessions for myself :) you know, surprisingly (surprisingly because a shoemaker, as they say, without boots always) learned a little. She unwound two turns herself two or three weeks before the due date, as a result, she went to the birth with one entanglement and everything went perfectly!
If I can be of any help to you (free of charge) write with pleasure I will help!
[email protected] 20.02.2018 22:13:41, Anna Korneva

The doctor is absolutely right! So what are the reasons → The doctor is absolutely right! So there is no reason to worry
And about the knot .. I won’t argue with you) I’ll just express my opinion: the umbilical cord is very elastic and resembles a silicone flagellum. If you tie such a flagellum into a knot, then of course it will make a knot, but then it will untie :) like hair, try it on them! By the way, an excellent exercise for auto-training: comb your hair in the morning / evening, take the lock into a knot, tie it and when it is untied aloud to yourself (and to the baby) "as my hair is untied, so your baby will untie the umbilical cord knot easily and quickly"
In all seriousness, just try it - an attempt is not torture :) 20.02.2018 22:51:34, Anna Korneva

Mom, don't worry, everything will be fine → Mom, don't worry, everything will be fine and give birth naturally! My daughter-in-law was just as afraid ... there were weekly CTG and DG and entanglement of the umbilical cord around the neck of the fetus and threatened with a caesarean section! Everything was resolved by natural childbirth and appeared ?? wonderful girl with a good weight and height! And you will be fine! 02/21/2018 00:22:37, Alsu Anvarova

I gave birth to a son EP with an entanglement and a knot on → I gave birth to a son EP with an entanglement and a knot on the umbilical cord. The "specialists" in the LC did not find any entanglement or ultrasound knot on any ultrasound. Only upon admission to the RD was told about a possible node. 21.02.2018 00:46:17, Nikalexna

Don't worry, my son has too → Don't be discouraged, my son also had an entanglement of the umbilical cord and a knot. Now I have already graduated from the Mountain School, everything is fine, I gave birth myself 02/21/2018 01:52:14, Julia

It happens. Everything will be fine) → It happens. Everything will be fine) 02/21/2018 08:22:55, Ekaterina I

Dear author, do not be afraid of the COP, me with → Dear author, do not be afraid of the COP, I was having a consultation with the twins, is it possible for EP, they decided that it was possible, that for a double pregnancy and a small size of the abdominal cavity, I wore surprisingly well and had to handle it myself. But fate decreed otherwise, I had an emergency CS. Later, 2 independent specialists confirmed that in my case, the EP could have ended very sadly.
In my opinion, if you can give birth on your own, then it is better to give birth on your own, if there are problems, then PCS is a very good way out. Everything will be fine! 02/21/2018 10:07:54 am, Imuranka

I have three children and all are born with → I have three children and all were born with cord entanglement All children are healthy 28 years old 18 years old and 9 years old 02/21/2018 18:23:07, Tatyana1972

Start from what will be best for → Decide what is best for the child. In any case, I thought in this vein :)) PCS is not so scary (I'm not a theorist), but health problems are much less likely with your history. Good luck to you, let everything be fine :) Maybe it's better to go to bed early for preservation, at least to do CTG more often? But I’m generally a reinsurer, of course, I don’t know about you, I would definitely have surrendered to the doctors earlier, I would have been calmer. Today I was at the repeated DG and CTG in the KRD - everything is fine, we continue to observe ... 26.02.2018 18:45:23, SunReg

a hope is a twisted tube, similar to a spiral telephone cord. It is necessary for the connection of the fetus with the placenta and the exchange of substances between mother and fetus.

Attachment of the placenta

Normally, the umbilical cord is attached to the placenta, but sometimes it attaches to the fetal membranes. In itself, such an attachment is not a complication, but in this situation, pregnancy should be taken more carefully, since placental insufficiency may occur, that is, a sufficient amount of oxygen and nutrients will not be supplied to the fetus.

Umbilical cord knots

On ultrasound, thickening of the umbilical cord can be seen. They are called nodes. Umbilical cord nodes are true and false. False nodes occur due to varicose veins of the umbilical vein. They do not affect the course of pregnancy and the health of the baby. But there are also true umbilical cord knots that look the same, but are dangerous to the fetus. They are formed in early pregnancy, when the fetus floats freely in the uterus. Sometimes the embryo manages to tie the umbilical cord in a knot, but while the fetus is still small, it does not have enough strength to tighten the tight knot, but in the second trimester of pregnancy this knot may tighten, which will cause fetal hypoxia. If the knot is pulled tight, which, fortunately, does not happen too often, the fetus may die. True knots are also dangerous in childbirth, because when the fetus passes through the birth canal, the umbilical cord stretches, tightening the knot, which causes acute fetal hypoxia. Therefore, if umbilical cord nodes are suspected, it is necessary to monitor changes in ultrasound throughout the pregnancy, regularly do CTG, and from the third trimester of pregnancy, carefully monitor the nature of fetal movements: too active fetal movements or their complete absence are a reason for immediate medical attention.

Umbilical cord shortening

When the umbilical cord is shortened, its length is less than 45 cm. During pregnancy, this is not dangerous, but too short an umbilical cord is dangerous in childbirth, since it will completely stretch before the child passes the birth canal. With further advancement of the baby through the birth canal, the umbilical cord can pull the placenta along with it, as a result, the placenta will exfoliate ahead of time, which can threaten the life of the mother and child. Many factors need to be taken into account when a shortening of the umbilical cord is identified in order to make a decision about the management of labor, including the site of attachment of the placenta and umbilical cord in the uterus.

cord entanglement

During pregnancy, entanglement of the umbilical cord occurs. This condition is not dangerous for the pregnant woman and the fetus. The danger can be multiple entanglement of the umbilical cord during childbirth.

The organisms of a pregnant woman and a child are connected to each other with the help of the umbilical cord. This special organ is formed from the 2nd week of gestation and from the very appearance provides nutrition and breathing for the baby in the womb. In rare cases, pathological nodes (true or false) are formed on the umbilical cord, which do not pose a threat to the life of the child, but can cause complications of pregnancy and childbirth.

What is a true umbilical cord knot

The umbilical cord is a dense tissue tube twisted in a spiral. It connects the placenta, the fetus and the mother's body. The body consists of large vessels, which are enclosed in a protective sheath. The vein carries blood with oxygen and nutrients from the mother's body to the baby. Two arteries transport processed blood with metabolic products back to the placenta.

The formation of the umbilical cord begins at 2 weeks, and by the time of birth it reaches about 20 mm in diameter and 50–60 cm in length.

Despite the spiral shape, the tube remains homogeneous, which allows oxygen and food components to freely enter the child's body. But sometimes the umbilical cord is twisted, as a result of which true knots (one or more) appear on her body. The root cause of the pathology is too active and chaotic movements of the fetus in the womb in the first trimester. But knots can also form in the later stages.

True umbilical cord nodes are diagnosed, according to various sources, in 0.04–2.5% of pregnancies. It is believed that they increase the risk of morbidity in newborns up to 11%. Perhaps this is due to the fact that the knots can be dense and tight, as a result of which the choroid plexus of the tube is damaged, and the child does not receive the nutrients necessary for the formation and development. Also, in the area of ​​​​the node, varicose veins of the navel, blood clots often occur, which negatively affects the trophism of the area.

false knot

Such nodes are seals on the umbilical cord, which can be caused by varicose veins of the area, the accumulation of jelly (the material for building the tube), the kink of blood vessels, blood clots, etc. In a false node, the vessels are elongated and dilated, twisted or displaced. That is, in their structure, these formations are not knots - twisted and tightened sections of the umbilical cord.

The causes of the appearance of false nodes are considered to be varicose veins, their natural tortuosity, as well as the displacement of Wharton's jelly during the formation of the umbilical cord.

This type of nodes, unlike the true ones, does not pose risks to the life and health of the mother and baby. It is also not an indication for an elective or emergency caesarean. But during childbirth at the stage of active contractions and attempts, the obstetrician must control the degree of tension of the umbilical cord in order to prevent its premature rupture.

Causes of True Knots

In medicine, several possible causes of this pathology are determined.

1. The umbilical cord of the fetus is very long.
2. Chaotic active movements of the fetus in the first trimester. The movement of the baby in the womb leads to the fact that the umbilical cord can fold into a loop and tighten, causing the vessels to form a knot.
3. Multiple pregnancy is also a predisposing factor for the appearance of defects (two umbilical cords can become entangled and form a knot).
4. With polyhydramnios, the umbilical cord, under the pressure of a significant volume of fluid, moves more often in the womb and can become tangled.
5. An association has been seen between gestational or diabetes mellitus in pregnancy and the risk of true nodules.
6. During the procedure of amniocentesis (taking amniotic fluid for genetic research), the mobility of the fetus increases and the muscles of the uterus are activated, which can provoke the appearance of defects on the umbilical cord.

What are the dangers of true knots for a child

In most cases, such pathologies do not affect the formation and development of the embryo, only indirectly affect the nature of labor. But in 10% of cases, excessive squeezing of the umbilical cord vessels can stop the access of nutrients and oxygen to the child. As a result, acute hypoxia occurs, which increases the risk of intrauterine fetal death. The likelihood also increases during delivery, when there is the greatest activity of mother and child.

When diagnosing the knot of the umbilical cord, dopleometry is performed, which can detect hypoxia of the baby. If an ultrasound scan detects fetal oxygen deficiency, an emergency caesarean section is prescribed.

Also, with multiple true nodes, a shortening of the umbilical cord may occur, which increases the risk of it.
As statistics show, in children with true umbilical cord nodes, the risk of congenital pathologies increases, and perinatal mortality is up to 11% of cases. During childbirth, the probability of fetal death increases up to 10 times.

During the examination, the doctor pays attention to the degree of tightening of the knot, its diameter and the clearance of the umbilical cord. Normally, it should be more than 1.5 cm, but if the indicators are less, then there may be a violation of blood flow in the vessels of the placenta and fetus.

A false knot does not pose a threat to the life and health of the child.

Methods for the diagnosis and treatment of a true umbilical cord knot

Pathology is detected thanks to an ultrasound machine and dopleometry, which shows the exact location of the node - in this area, the blood flow is directed in the opposite direction. Diagnosis is complicated by the fact that it is impossible to visualize all segments of the umbilical cord.

Cardiotocography allows you to diagnose the true nodes and the prenatal state of the child in late pregnancy, as well as during childbirth.

False nodes are determined using an ultrasound machine - on the monitor they are represented by growths on the umbilical cord.

A pregnant woman can independently suspect a pathology, for example, if the baby's movements during the day become too active or absent altogether.

False nodes do not pose a threat to the life of the mother and baby, and also have no clinical significance, so their therapy is not indicated.

True nodes are not amenable to medical or surgical treatment. The doctor performs an emergency cesarean operation in case of complications - cord entanglement, fetal hypoxia, etc.

The true knot of the umbilical cord is a rather rare pathology, which only in 10% of cases leads to abnormalities in the development of the fetus or its intrauterine death. Timely ultrasound examination allows you to identify pathological formations and monitor the condition of the baby. To prevent hypoxia and other complications with true nodes, a caesarean section is often prescribed.

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