Nudo verdadero de cordón umbilical “revisión bibliográfica”

Abstract

The true knot of the umbilical cord is a potentially serious complication that can occur during pregnancy, it ranges between 0.3% and 2.1% of pregnancies, occurs because of a long or coiled umbilical cord, which by its length tends to intertwine completely at the ends on one or more occasions, in most cases tends to be asymptomatic and does not cause problems, It is important to mention that in spite of being an asymptomatic pathology in rare cases it can affect the flow of blood and fetal oxygen, which can cause growth problems, fetal hypoxia, heart failure and other serious complications such as fetal death. Treatment for a true umbilical cord knot depends on the severity of the situation. In some cases, a cesarean section may be recommended to ensure the safety of the fetus. In other cases, the fetus may be carefully monitored during delivery for any signsof problems and action taken as needed. True umbilical cord knots are rare and cannot be prevented. However, there are certain risk factors that may increase the likelihood of occurrence, such as having a long umbilical cord or having a fetus that makes accelerated movements intrauterine. If the presence of a true umbilical cord knot is suspected, it is important to receiveimmediate medical attention to minimize any risk to the fetus. In this research we will focus on reviewing the causes, risk factors, diagnosis and treatment of true umbilical cord knotting. Objective: Describe the main causes of the true umbilical cord knot, complications, risk factors, symptoms, diagnosis and treatment. Method: A descriptive and retrospective bibliographic review of documents published by scientific societies dedicated to collecting evidence on the treatment of overactive bladder syndrome, as well as research papers and scientific articles that describe the causes and treatment of OAB, was carried out. To locate the bibliographic documents, several documentary sources and guides published by different local and international professional associations of urology were reviewed. An exhaustive search was generated in repositories and scientific databases such as Pubmed, Scielo, Springer, MedLine, Redalyc, Dialnet, New England Journal of Medicine with the use ofdescriptors in both English and Spanish and the use of DeCs and MeSH (Urinary Bladder) thesauri.Overactive, Lower Urinary Tract Symptoms, Overactive Detrusor, Pelvic Floor). The final samples among all the reviewed databases were 30 articles in 30 Spanish and 20 articles in English. The inclusion standards for this review are as follows. Articles published from 2019 to this year and directly related to the research variables are articles belonging to the search engine selected for this review. In the same way, articles that did not correspond to the variable research, and that didnot belong to the selected sources, were excluded. Subsequently, an exhaustive reading of the names and the curriculum of each article is carried out to see which of them best adapt to thevariables of this review, thus receiving the number of articles with specific and useful information for the effective development of this study. Results: Fetal monitoring is important for the detection of this pathology, and if it occurs, fetuses should be subjected to continuous fetal surveillance to detect any signs of fetal distress. This may include tests of fetal well-being, such as electronic fetal monitoring or fetal heart rate tests. Childbirth planning is a helpful tool since control is maintained even before conception, since it includes a careful evaluation during all trimesters of pregnancy, allowing us to detect the presenceof this pathology early. In some cases, a cesarean delivery may be necessary to reduce the risk ofmaternal-fetal complications during vaginal delivery. Antenatal care is substantial and pregnant women should be advised to attend their antenatal care appointments on a regular basis to ensure that any problems, such as a true umbilical cord knot, are detected in time so that appropriatemeasures can be taken if they arrive. to present this pathology without endangering the life of the mother or the fetus. Tobacco and alcohol should be avoided during pregnancy because they increase the risk of complications during pregnancy, including the true knot of the umbilical cord. Insummary, the true umbilical cord knot is a potentially serious complication of pregnancy, but preventative measures can be taken to reduce the risk of complications and ensure a successful outcome for mother and fetus before, during, and after delivery. Conclusion: The diagnosis of a true umbilical cord knot is based on clinical evaluation and theuse of diagnostic techniques, such as prenatal ultrasound and fetal monitoring. If a true umbilical cord knot is suspected, it is important to seek medical attention immediately to avoidserious complications for the fetus. Treatment of a true umbilical cord knot will depend on theseverity of the complication and the health of the fetus. If a true umbilical cord knot is suspected, it is important to seek medical attention immediately to avoid serious complicationsfor the fetus. Some of the maternal and fetal risk factors for true umbilical cord knot include multiple pregnancy, polyhydramnios, fetal malformations, history of true umbilical cord knot, advanced maternal age, and fetal sex. If a pregnant woman has one or more of these risk factors, it is important to discuss the possibility of a true umbilical cord knot with her doctor and take the necessary precautions.