True Knot of the Umbilical Cord in a near Term Pregnancy Undergoing Spontaneous Vaginal Delivery

A near term pregnant ( 36+4 weeks of gestation ) woman presented with premature rupture of the membranes ( PROM ). Misoprostol was then given for induction of labor. The course of labor and fetal heart rate were normal. Spontaneous vaginal delivery was achieved. At delivery, two loops of nuchal cord with true knot of the umbilical cord were noted. The male infant was born with birth weight of 2730 gm ad Apgar scores of 8 and 10 at 1 and 5 minutes, respectively. The case presented here suggests that true knot of the umbilical cord is not always contraindication for vaginal delivery. As long as fetal surveillance shows reassuring, cesarean section may be unnessesary. Chiang Mai Medical Jounal 2008;47(1): 33-37.