{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:45:23Z","timestamp":1760143523479,"version":"build-2065373602"},"reference-count":11,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T00:00:00Z","timestamp":1708128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>A 36-year-old woman, gravida 3, para 1 (previous cesarean section), with one medical abortion, and no history of systemic diseases presented an unremarkable medical history during prenatal visits. The final prenatal ultrasound at 38 weeks of gestation showed a vertex presentation, a weight of 2600 g, a normal amniotic fluid level, and the placenta located on the posterior wall of the uterus. Fetal cardiotocography conducted before delivery reported a reactive heart rate without decelerations. The Doppler wave analysis of the fetal umbilical artery was normal (the ratio of peak-systolic flow velocity to the end-diastolic flow velocity was 2.5) without the absence or reversal of end-diastolic velocity. The total score of the fetal biophysical profile by ultrasound was 8. The night before the scheduled cesarean section, she experienced heightened anxiety and was unable to sleep, noting \u201ccrazy\u201d fetal movements throughout the night. During the cesarean section, it was discovered that the umbilical cord was wrapped around the newborn\u2019s legs, resembling ankle shackles. The fetal weight was 2740 g, and Apgar scores were 9 at the first minute and 10 at the fifth minute. The motility of the neonatal legs was normal without cyanosis or neurological adverse outcomes.<\/jats:p>","DOI":"10.3390\/diagnostics14040444","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T04:36:22Z","timestamp":1708403782000},"page":"444","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Umbilical Cord Wraps around a Newborn\u2019s Legs like Ankle Shackles"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6403-7596","authenticated-orcid":false,"given":"Kun-Long","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Collage of Medicine, Kaohsiung 833401, Taiwan"},{"name":"Department of Obstetrics and Gynecology, Jiannren Hospital, Kaohsiung 811020, Taiwan"},{"name":"Department of Obstetrics and Gynecology, Fangliao General Hospital, Pingtung 940004, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching-Chang","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Collage of Medicine, Kaohsiung 833401, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsin-Hsin","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Collage of Medicine, Kaohsiung 833401, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun-Ju","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Collage of Medicine, Kaohsiung 833401, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei-Fang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Collage of Medicine, Kaohsiung 833401, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Te-Yao","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Collage of Medicine, Kaohsiung 833401, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1016\/j.tjog.2018.09.001","article-title":"Multiple part umbilical cord entanglement and neonatal outcomes","volume":"57","author":"Mariya","year":"2018","journal-title":"Taiwan. J. Obstet. Gynecol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.ejogrb.2019.10.038","article-title":"Evaluation of umbilical cord entanglement as a predictive factor of adverse pregnancy outcomes: A meta-analysis","volume":"243","author":"Pergialiotis","year":"2019","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s40748-017-0068-7","article-title":"Nuchal cord and its implications","volume":"3","author":"Peesay","year":"2017","journal-title":"Matern. Health Neonatol. Perinatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1002\/ijgo.14992","article-title":"Adverse outcomes of nonnuchal umbilical cord entanglement","volume":"164","author":"Beer","year":"2024","journal-title":"Int. J. Gynaecol. Obs."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1007\/s13224-012-0194-0","article-title":"Study of length of umbilical cord and fetal outcome: A study of 1,000 deliveries","volume":"62","author":"Balkawade","year":"2012","journal-title":"J. Obstet. Gynecol. India"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"247","DOI":"10.2147\/IJWH.S285860","article-title":"Current Perspectives of Prenatal Sonographic Diagnosis and Clinical Management Challenges of Complex Umbilical Cord Entanglement","volume":"13","author":"Sherer","year":"2021","journal-title":"Int. J. Womens Health"},{"key":"ref_7","unstructured":"(2018). AIUM-ACR-ACOG-SMFM-SRU Practice Parameter for the Performance of Standard Diagnostic Obstetric Ultrasound Examinations. J. Ultrasound Med., 37, E13\u2013E24."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1002\/uog.7501","article-title":"Cord entanglement and perinatal outcome in monoamniotic twin pregnancies","volume":"35","author":"Dias","year":"2010","journal-title":"Ultrasound Obs. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.bpobgyn.2022.08.004","article-title":"Monochorionic monoamniotic twin pregnancies","volume":"84","author":"Khairudin","year":"2022","journal-title":"Best. Pr. Res. Clin. Obs. Gynaecol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.mehy.2017.12.024","article-title":"Excessive fetal movements are a sign of fetal compromise which merits further examination","volume":"111","author":"Heazell","year":"2018","journal-title":"Med. 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Biol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/4\/444\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:01:15Z","timestamp":1760104875000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/4\/444"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,17]]},"references-count":11,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["diagnostics14040444"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14040444","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2024,2,17]]}}}