ArticleArchives of gynecology and obstetrics2025
The impact of true knot of umbilical cord on obstetric outcomes-true or not?
Article in Archives of gynecology and obstetrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Prevention of stillbirths associated with umbilical cord abnormalities: A clinico-pathological overview.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Review
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo quantify the risk of true cord of the umbilical cord for perinatal death and identify additional risk factors.
methodsThis retrospective study included singleton deliveries between 24 and 42 weeks of gestation that took place between 2003 and 2017 in two medical centers. For patients with true knot, data regarding the number of cord knots as well as the location and number of loops of cord were obtained. The rest of the birth data set comprised the control group. The primary outcome was fetal demise. Secondary outcomes included mode of delivery and perinatal outcomes.
resultsThe final data set included 139,458 deliveries, of which 364 cases (0.26%) comprised the study group (true knot group) and 139,094 cases (99.74%) the control group. Higher rated of unfavorable outcomes were found among cases than controls, including perinatal death, delivery mode, lower Apgar and cord blood umbilical artery pH as well as higher rates of NICU admission and perinatal death. Multivariate analysis showed that true knot of cord (aOR 15.46, 95% CI 9.30-25.70) was a strong predictor of perinatal death. Analysis of predictors of perinatal death within the study group showed that only four or more nuchal loops of cord was an independent predictor (four loops OR 13.40 95% CI 1.12-160.34).
conclusionsTrue knot of the umbilical cord is a strong predictor of perinatal death. Fetuses with true knot of cord and four or more nuchal cord loops are at significantly increased risk of perinatal death. If diagnosed before onset of labor, delivery before 37 weeks may prevent perinatal death.
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