Revista chilena de obstetricia y ginecología
versión On-line ISSN 0717-7526
HASBUN H, Jorge; MUNOZ C, Hugo y SEPULVEDA L, Waldo. EXPERIENCIA COMUNICACIONAL EN EL DIAGNÓSTICO Y MANEJO ANTENATAL DE NUDO DEL CORDÓN UMBILICAL. Rev. chil. obstet. ginecol. [online]. 2010, vol.75, n.3, pp. 207-212. ISSN 0717-7526. http://dx.doi.org/10.4067/S0717-75262010000300012.
We report a case of a pregnant woman who presented with absence of fetal movement at the 31st gestational week. The ultrasound (US) images (gray scale, color Dopplerand 3 dimensional) clearly suggested a true knot of the umbilical cord. A close surveillance regime with daily fetal movement test, fetal electronic monitoring and umbilical hemodynamics with Doppler, alternated every three days, was kept for seven weeks, showing fetal wellbeing. At week 37, a cesarean section was performed because of a previous uterine scar. The intraoperative finding confirmed agglutinated and twisted loops, but not a knot of the umbilical cord. The antenatal management is discussed with a close fetal monitoring to detect eventual vascular occlusion in a tight knot and the communication experience with the mother in order to understand and accept a false positive US diagnosis. Conclusion: During a maternal and fetal high risk management is important the professional experience and technological support. On the other hand, the best medical patient communication through an empathetic alliance is required in order to reach a psychological support, longer gestational age and better understanding a false positive test.
Palabras llave : Umbilical cord; true knot; prenatal ultrasound.