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脐带真结的产前诊断：1例罕见病例及成功手术结果

Antenatal Diagnosis of a True Knot of the Umbilical Cord: A Rare Case With a Successful Surgical Outcome.

作者信息

Gupta Sarmistha, Srinivasan Rajalakshmi

机构信息

Radiology, Medcare Royal Speciality Hospital, Dubai, ARE.

Obstetrics and Gynecology, Medcare Royal Speciality Hospital, Dubai, ARE.

出版信息

Cureus. 2025 Jun 15;17(6):e86095. doi: 10.7759/cureus.86095. eCollection 2025 Jun.

DOI:10.7759/cureus.86095
PMID:40671969
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12264308/
Abstract

True knots of the umbilical cord (TKUCs) are rare and can compromise fetal well-being. Their diagnosis is typically made at delivery, with antenatal identification remaining rare. This case report describes an antenatal diagnosis of a TKUC at 35 weeks' gestation in a 28-year-old third gravida with two previous miscarriages. The patient presented with reduced amniotic fluid and absent fetal movements. Ultrasound imaging raised suspicion of a TKUC, prompting an emergency cesarean section. A healthy neonate was delivered. This case highlights the potential role of color Doppler ultrasound and maternal vigilance in identifying TKUCs before delivery. Despite diagnostic challenges, heightened clinical awareness and timely intervention can contribute to favorable perinatal outcomes. Future research should aim to improve diagnostic accuracy and develop effective risk-stratification tools.

摘要

脐带真结（TKUCs）较为罕见，可能危及胎儿健康。其诊断通常在分娩时作出，产前诊断仍然少见。本病例报告描述了一名28岁、孕3产、前两次流产的孕妇在妊娠35周时产前诊断出脐带真结。患者出现羊水减少和胎动消失。超声成像提示怀疑有脐带真结，遂行急诊剖宫产。娩出一名健康新生儿。本病例突出了彩色多普勒超声和孕妇警惕性在分娩前识别脐带真结方面的潜在作用。尽管存在诊断挑战，但提高临床意识和及时干预有助于获得良好的围产期结局。未来的研究应致力于提高诊断准确性并开发有效的风险分层工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41a4/12264308/eef6a62c2395/cureus-0017-00000086095-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41a4/12264308/f7f05ee10e39/cureus-0017-00000086095-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41a4/12264308/96e632f366e9/cureus-0017-00000086095-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41a4/12264308/eef6a62c2395/cureus-0017-00000086095-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41a4/12264308/f7f05ee10e39/cureus-0017-00000086095-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41a4/12264308/96e632f366e9/cureus-0017-00000086095-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41a4/12264308/eef6a62c2395/cureus-0017-00000086095-i03.jpg

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本文引用的文献

1
Double and Single True Knot of an Umbilical Cord: A Case Report.脐带双真结与单真结：一例报告
Cureus. 2023 Mar 20;15(3):e36393. doi: 10.7759/cureus.36393. eCollection 2023 Mar.
2
A misdiagnosed case of a 150-cm umbilical cord coiled twice around the fetal neck with a true cord knot: A rare Syrian case report.一例罕见的叙利亚病例报告：脐带长150厘米，绕胎儿颈部两周并伴有真结，诊断有误
SAGE Open Med Case Rep. 2023 Apr 2;11:2050313X231164858. doi: 10.1177/2050313X231164858. eCollection 2023.
3
True Knot of the Umbilical Cord and Associated Adverse Perinatal Outcomes: A Case Series.
脐带真结及相关围产期不良结局：病例系列
Cureus. 2023 Feb 23;15(2):e35377. doi: 10.7759/cureus.35377. eCollection 2023 Feb.
4
Adverse Perinatal Outcomes of True Knot of the Umbilical Cord: A Case Series and Review of Literature.脐带真结的不良围产期结局：病例系列及文献综述
Cureus. 2022 Jul 18;14(7):e26992. doi: 10.7759/cureus.26992. eCollection 2022 Jul.
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True double umbilical cord knot.真性双脐结
BMJ Case Rep. 2022 Aug 11;15(8):e251388. doi: 10.1136/bcr-2022-251388.
6
Umbilical Cord Knots: Is the Number Related to Fetal Risk?脐带结：数量与胎儿风险有关吗？
Medicina (Kaunas). 2022 May 25;58(6):703. doi: 10.3390/medicina58060703.
7
Current Perspectives of Prenatal Sonographic Diagnosis and Clinical Management Challenges of True Knot of the Umbilical Cord.脐带真结的产前超声诊断现状及临床管理挑战
Int J Womens Health. 2020 Mar 27;12:221-233. doi: 10.2147/IJWH.S192260. eCollection 2020.
8
True umbilical cord knot, an emergency during labor.真性脐带打结，分娩时的一种急症。
Clin Case Rep. 2019 Oct 13;7(11):2242-2244. doi: 10.1002/ccr3.2441. eCollection 2019 Nov.
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True knot at the time of delivery: electronic fetal monitoring characteristics and neonatal outcomes.分娩时的真结：电子胎儿监护特征与新生儿结局。
J Perinatol. 2018 Dec;38(12):1620-1624. doi: 10.1038/s41372-018-0250-4. Epub 2018 Oct 15.
10
One long umbilical cord, four nuchal cord loops and a true knot.一条长脐带，四个脐带绕颈圈及一个真结。
BMJ Case Rep. 2017 Dec 7;2017:bcr-2017-223241. doi: 10.1136/bcr-2017-223241.