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True Knot of Umbilical Cord
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True Knot of Umbilical Cord

Most of the photograph shows an umbilical cord.
There is a knot in the center of the cord.
There is no swelling or hemorrhage in the cord indicating that the knot did not compress blood vessels.
(Description By:Melinda Sanders, M.D. )
(Image Contrib. by: Hartford Hospital )
Umbilical Cord Knot
Etiology

excessively long umbilical cord (normal=54-61 cm)
Pathogenesis

probably fetal movement with a long cord allows knotting,
Epidemiology

0.4-0.5% of deliveries
General Gross Description

The umbilical cord is tied in a true knot
Loose knots which do not affect circulation in cord show no color changes or swellings
Tight knots which do affect the circulation lead to hemorrhage on the fetal side of the knot and edema on the placental side
General Microscopic Description

Tight knots can have compression of Wharton's jelly and mural thrombosis in umbilical vessels
Clinical Correlation

associated fetal mortality = 10%
References

Benirschke,Kurt and Kaufmann,Peter Pathology of the Human Placenta, 2nd edition, New York: Springer-Verlag, 1990, p213-14.
Salafia and Popek "Placenta" (Chaper 69) in Damjanov and Linder (eds) Anderson's Pathology 10th edition, St Louis: Mosby
Umbilical Cord Knot
Synopsis by: Linda Ernst (T88800M29700)[229]
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