- 1 in 100 pregnancies.
- Visualisation of a transverse section of the umbilical cord surrounded by a loop of umbilical cord: ‘hanging noose sign’.
- Predisposing factors include: long cord, small fetus, polyhydramnios, monoamniotic twins.
- Detailed ultrasound examination.
- Routine surveillance of the umbilical cord for knots may not be justifiable because it is time consuming and of uncertain sensitivity or benefit.
- The detection of an umbilical cord knot is not an indication for delivery unless associated with evidence of fetal compromise, such as abnormal fetal heart rate pattern.
- Closer fetal surveillance by fetal Dopplers and cardiotocography should be considered.
- Risk of stillbirth is increased by 5 times.
- No increased risk of recurrence.