Fetal arterial redistribution indicating true umbilical cord knot.
True umbilical cord knot often remains undiscovered prenatally due to a lack of characteristic clinical or ultrasound signs. We present a pregnancy with favorable outcome in which a non-stress test (NST) found non-reassuring fetal status. Abnormal Doppler blood flow patterns in the descending aorta and in the middle cerebral artery revealed fetal arterial redistribution with normal circulation in the umbilical artery despite a true cord knot. The benefit of fetal Doppler assessment is discussed. Increased aortic-cerebral ratio may reflect acute hypoxic compromise caused by the transitory constriction of the true umbilical cord knot with unrecognized morphologic and circulatory signs.
Aranyosi
János
J
Department of Obstetrics and Gynecology, Medical and Health Science Center of Debrecen, University of Debrecen, Nagyerdei krt. 98, P.O. Box 37, H-4012, Debrecen, Hungary. aranyosij@yahoo.com
Major
Tamás
T
Fülesdi
Béla
B
Zatik
János
J
D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging; D001783:Blood Flow Velocity / Q000502:physiology; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D005260:Female; D005333:Fetus / Q000098:blood supply*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D014470:Umbilical Cord / Q000033:anatomy & histology* / Q000000981:diagnostic imaging