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Three‐Dimensional Power Doppler Sonography in the Prenatal Diagnosis of a True Knot of the Umbilical Cord
Author(s) -
Hasbun Jorge,
Alcalde Juan L.,
Sepulveda Waldo
Publication year - 2007
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2007.26.9.1215
Subject(s) - medicine , umbilical cord , cord , prenatal diagnosis , in utero , knot (papermaking) , single umbilical artery , obstetrics , power doppler , fetus , radiology , pregnancy , surgery , ultrasonography , anatomy , genetics , chemical engineering , biology , engineering
Objectives The purpose of this study was to examine the value of 3‐dimensional power Doppler sonography in the prenatal diagnosis of a true knot of the umbilical cord. Methods Cases in which the diagnosis of a true knot of the umbilical cord was suspected by prenatal 2‐dimensional sonography were reviewed. The presumably affected segment of the cord was examined with 3‐dimensional power Doppler sonography for further characterization. Confirmation of the prenatal diagnosis was sought by reviewing the delivery records and contacting the referring obstetrician and the patients themselves. Results Eight consecutive cases were studied. Three‐dimensional power Doppler sonography displayed a vascular spatial configuration pattern consistent with a true knot of the umbilical cord in all of them. However, the prenatal diagnosis was confirmed at delivery in only 5 cases (62.5%). Although there were no cases of a false knot mimicking a true knot of the umbilical cord, all incorrect diagnoses in this series were associated with multiple loops of the umbilical cord in the third trimester. Conclusions Three‐dimensional power Doppler sonography seems to be helpful in determining the presence of a true knot of the umbilical cord in utero, especially in the second trimester. However, this should not be considered a definitive method for the diagnosis because multiple loops of the umbilical cord lying close to each other can generate a sonographic image that can be undistinguishable from a true knot of the umbilical cord prenatally, especially when located in a small pocket of amniotic fluid. Therefore, the presumable diagnosis of a true knot of the umbilical cord in utero should be taken with caution.