True Knots

True knots are meant to be quite rare (less than 1% of all births)

I've had 4 or 5 true knots (my first was actually my 13th birth as a student midwife) - all of which have been normal births, often with decelerations and a quick 2nd stage (not sure if nature knows it can't let the cord be occluded for too long) - including 2 in the past month, one a double knot and the last like the one below (double knot I mean cord goes back through the existing knot like a figure of 8). I've also found about half of the knots have coincided with a velementous insertion

I think I must enthuse about them when I find them, because I always show the parents and twice now the dad's have taken photos of the knot (one said it was a sign baby was going to be a fisherman when he was older as he'd already tied a reef knot)




Just wondered if others had had experience with them

Oh i've not seen any but that's brilliant to see! How crazy that you've seen so many.

Question, what is a velementous insertion ?

I've seen one, like you said, lots of decels and a very quick second stage, but it was her fourth so might have been quick anyway.

Velamentous insertion:
Velamentous insertion means that the veins, unprotected by Wharton's jelly, traverse the membranes before they come together into the umbilical cord. The umbilical cord inserts on the placental mass in about 99% of cases. The insertion site may vary from the center of the fetal surface to the border of the placenta. The term velamentous insertion is used to describe the condition in which the umbilical cord inserts on the chorioamniotic membranes rather than on the placental mass.
Therefore, a variable segment of the umbilical vessels runs between the amnion and the chorion, losing the protection of the Wharton's jelly.
The incidence of this condition is about 1.1% in singleton pregnancies and 8.7% in twin gestations.

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We had one that had THREE true knots, the cord around it's neck twice and under it's arm! I think they had a little gymnast in there.... Deep deep decels in second stage and ended up as a Ventouse delivery.

I've seen one, too. It was knotted twice in deifferent places and also wrapped around the baby's neck and under it's arm - fortunately it was a long cord. The parents think baby will be in the cirque de soleil from al the gymnastics, twisting himself into knots!