Four True Umbilical Cord Knots

Background: True umbilical cord knots are rare, but may be associated with intrapartum fetal distress and perinatal complications. Case: This report describes a pregnancy complicated by intrauterine growth restriction and oligohydramnios. The labour was complicated by a non-reassuring fetal heart rate tracing. Four umbilical cord knots were discovered at the time of delivery. The baby's neonatal course was uncomplicated. Conclusion: There is currently no reliable method of detecting umbilical cord knots using ultrasound or colour Doppler flow studies. Cord knots may be responsible for fetal compromise during labour and delivery.