True umbilical cord knot detection via active scanning: a prospective study on accuracy and visualization factors

Abstract Background True umbilical cord knot (TUCK) is frequently missed in prenatal ultrasound (US), hindering standardized management and risk assessment of adverse perinatal outcomes. This study aimed to assess TUCK detection accuracy using active umbilical cord (UC) scanning and identify factors...

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Main Authors: Junyan Cao, Zhaocong Chen, Minhong Zou, Miao Zhong, Ying Chen, Xin Lin, Manli Wu, Qiaoyuan Wang, Xinling Zhang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Pregnancy and Childbirth
Subjects:
Online Access:https://doi.org/10.1186/s12884-025-07629-6
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author Junyan Cao
Zhaocong Chen
Minhong Zou
Miao Zhong
Ying Chen
Xin Lin
Manli Wu
Qiaoyuan Wang
Xinling Zhang
author_facet Junyan Cao
Zhaocong Chen
Minhong Zou
Miao Zhong
Ying Chen
Xin Lin
Manli Wu
Qiaoyuan Wang
Xinling Zhang
author_sort Junyan Cao
collection DOAJ
description Abstract Background True umbilical cord knot (TUCK) is frequently missed in prenatal ultrasound (US), hindering standardized management and risk assessment of adverse perinatal outcomes. This study aimed to assess TUCK detection accuracy using active umbilical cord (UC) scanning and identify factors affecting prenatal visualization. Methods A prospective study of 378 pregnant women (11–40 weeks) was conducted. Experienced and novice physicians sequentially scanned the full UC, grading umbilical cord ultrasonic image quality (UCUIQ) as sufficient (scale 1), restricted (scale 2), or poor (scale 3). Factors affecting UCUIQ were analyzed using multiple logistic regression, and diagnostic accuracy was evaluated. Cases for diagnosis were confirmed at delivery. Results Interobserver agreement for UCUIQ grading was excellent (К = 0.979). Gestational week emerged as the primary factor influencing UC visualization (P < 0.05), with ultrasound achieving a diagnostic accuracy of no less than 89.3% for TUCK detection during the 17–26 weeks gestational period. Conclusions Gestational week significantly influenced TUCK detection, with high accuracy at 17–26 weeks. Active UC scanning during this period improved detection accuracy of TUCK.
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issn 1471-2393
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series BMC Pregnancy and Childbirth
spelling doaj-art-9cfae388f7a6463f9db7bb83b588897d2025-08-20T03:52:20ZengBMCBMC Pregnancy and Childbirth1471-23932025-04-012511910.1186/s12884-025-07629-6True umbilical cord knot detection via active scanning: a prospective study on accuracy and visualization factorsJunyan Cao0Zhaocong Chen1Minhong Zou2Miao Zhong3Ying Chen4Xin Lin5Manli Wu6Qiaoyuan Wang7Xinling Zhang8Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Ultrasound, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Ultrasound, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Ultrasound, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Ultrasound, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Ultrasound, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Ultrasound, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Ultrasound, The Third Affiliated Hospital of Sun Yat-Sen UniversityAbstract Background True umbilical cord knot (TUCK) is frequently missed in prenatal ultrasound (US), hindering standardized management and risk assessment of adverse perinatal outcomes. This study aimed to assess TUCK detection accuracy using active umbilical cord (UC) scanning and identify factors affecting prenatal visualization. Methods A prospective study of 378 pregnant women (11–40 weeks) was conducted. Experienced and novice physicians sequentially scanned the full UC, grading umbilical cord ultrasonic image quality (UCUIQ) as sufficient (scale 1), restricted (scale 2), or poor (scale 3). Factors affecting UCUIQ were analyzed using multiple logistic regression, and diagnostic accuracy was evaluated. Cases for diagnosis were confirmed at delivery. Results Interobserver agreement for UCUIQ grading was excellent (К = 0.979). Gestational week emerged as the primary factor influencing UC visualization (P < 0.05), with ultrasound achieving a diagnostic accuracy of no less than 89.3% for TUCK detection during the 17–26 weeks gestational period. Conclusions Gestational week significantly influenced TUCK detection, with high accuracy at 17–26 weeks. Active UC scanning during this period improved detection accuracy of TUCK.https://doi.org/10.1186/s12884-025-07629-6PregnancyUmbilical cord knotUltrasoundPrenatal diagnosisGestational weeks
spellingShingle Junyan Cao
Zhaocong Chen
Minhong Zou
Miao Zhong
Ying Chen
Xin Lin
Manli Wu
Qiaoyuan Wang
Xinling Zhang
True umbilical cord knot detection via active scanning: a prospective study on accuracy and visualization factors
BMC Pregnancy and Childbirth
Pregnancy
Umbilical cord knot
Ultrasound
Prenatal diagnosis
Gestational weeks
title True umbilical cord knot detection via active scanning: a prospective study on accuracy and visualization factors
title_full True umbilical cord knot detection via active scanning: a prospective study on accuracy and visualization factors
title_fullStr True umbilical cord knot detection via active scanning: a prospective study on accuracy and visualization factors
title_full_unstemmed True umbilical cord knot detection via active scanning: a prospective study on accuracy and visualization factors
title_short True umbilical cord knot detection via active scanning: a prospective study on accuracy and visualization factors
title_sort true umbilical cord knot detection via active scanning a prospective study on accuracy and visualization factors
topic Pregnancy
Umbilical cord knot
Ultrasound
Prenatal diagnosis
Gestational weeks
url https://doi.org/10.1186/s12884-025-07629-6
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