True knot in umbilical cord as a cause of perinatal asphyxia: case report in a Hospital in Ayacucho, Peru
DOI:
https://doi.org/10.35563/rmp.v14i3.666Keywords:
Funicular dystocia, true knot, perinatal asphyxia, fetal deathAbstract
Introduction:
True knot of the umbilical cord is a rare but potentially lethal anomaly that can cause perinatal asphyxia and fetal death.
Case: We report the case of a 35-year-old primigravida at 27 weeks of gestation by last menstrual period (LMP), who presented to Coracora Support Hospital, Ayacucho, Peru, with vaginal bleeding and decreased fetal movements. Obstetric ultrasound revealed fetal demise at 25 weeks by fetal biometry. She was referred to Augusto Hernández Mendoza Hospital, where the diagnosis was confirmed, and a male fetus was extracted with a double nuchal cord and a true knot.
Discussion: True knots have an incidence of 0.5-1.25% and are associated with fetal hypoxia. This case highlights the limitations of prenatal care in rural settings. Conclusion: Improving access to diagnostic technologies such as Doppler ultrasound and strengthening prenatal care in low-resource settings is critical to prevent perinatal complications.
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Copyright (c) 2025 Gonzáles-Tipiana Ismael Rolando, Heredia-Chocce Jhime Rosella
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