[Epidemiology and clinical value of true umbilical cord knots].
OBJECTIVE
To evaluate the epidemiology of true knots of the umbilical cord and their impact on pregnancy outcome.


METHODS
22531 singleton deliveries were included in this retrospective study (1976-1994). Newborns with malformations were excluded. The database of the 2nd Department of Obstetrics and Gynaecology, Vienna University Hospital was analyzed.


RESULTS
The incidence of true knots was 1.27% (n = 286). Multiparous women are more likely to give birth to a child with a true knot of the umbilical cord than primiparae (1.52% vs. 1.01%, P < 0.001). Male fetuses are more frequently affected than females (1.49% vs. 1.04%, P = 0.01). Duration of pregnancy, fetal weight, presentation and mode of delivery are not significantly influenced by umbilical knots. Fetal acidosis (pH < 7.10) was more common in the cohort with true knots as compared with the controls (8.33% vs. 4.03%, P < 0.01). Apgar score and transfer rate to a neonatal unit were not influenced. Still-births were more common in the cohort with umbilical knots (1.7% vs. 0.6%, P < 0.05); there was no neonatal death in the cohort with true knots, however.


CONCLUSIONS
A fetus with a true knot of the umbilical cord is at risk for fetal death. During labour umbilical knots have no adverse effect on pregnancy outcome.
Joura
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Universitätsklinik für Frauenheilkunde Wien, Allgemeines Krankenhaus, Osterreich.
Zeisler
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Sator
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D001238:Asphyxia Neonatorum / Q000401:mortality*; D001317:Austria / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D014470:Umbilical Cord
Epidemiologie und klinische Wertigkeit von echten Nabelschnurknoten.