# Antenatal Diagnosis of a True Knot of the Umbilical Cord: A Rare Case With a Successful Surgical Outcome

## TL;DR

A rare case of a true umbilical cord knot was diagnosed before birth, leading to a successful surgical delivery and a healthy baby.

## Contribution

This case report presents a rare antenatal diagnosis of a true umbilical cord knot with a successful outcome.

## Key findings

- Antenatal diagnosis of a true umbilical cord knot was made at 35 weeks' gestation.
- Emergency cesarean section led to the delivery of a healthy neonate.
- Color Doppler ultrasound and maternal vigilance aided in the early detection.

## Abstract

True knots of the umbilical cord (TKUCs) are rare and can compromise fetal well-being. Their diagnosis is typically made at delivery, with antenatal identification remaining rare. This case report describes an antenatal diagnosis of a TKUC at 35 weeks’ gestation in a 28-year-old third gravida with two previous miscarriages. The patient presented with reduced amniotic fluid and absent fetal movements. Ultrasound imaging raised suspicion of a TKUC, prompting an emergency cesarean section. A healthy neonate was delivered. This case highlights the potential role of color Doppler ultrasound and maternal vigilance in identifying TKUCs before delivery. Despite diagnostic challenges, heightened clinical awareness and timely intervention can contribute to favorable perinatal outcomes. Future research should aim to improve diagnostic accuracy and develop effective risk-stratification tools.