Management of Umbilical Cord Knots During Labor

Intrapartum Management

• Indications for immediate cesarean delivery include variable fetal heart rate decelerations, abnormal Doppler flow studies, and signs of acute fetal distress, as recommended by the British Medical Journal 1

Active Management of Third Stage

• The British Medical Journal recommends administering oxytocin immediately after delivery, delaying cord clamping for approximately three minutes, and following with controlled cord traction for placental delivery to combine the benefits of delayed cord clamping with reduced risk of postpartum hemorrhage 1, 2