Abstract
True knots of the umbilical cord (TKUCs) are rare and can compromise fetal well-being. Their diagnosis is typically made at delivery, with antenatal identification remaining rare. This case report describes an antenatal diagnosis of a TKUC at 35 weeks' gestation in a 28-year-old third gravida with two previous miscarriages. The patient presented with reduced amniotic fluid and absent fetal movements. Ultrasound imaging raised suspicion of a TKUC, prompting an emergency cesarean section. A healthy neonate was delivered. This case highlights the potential role of color Doppler ultrasound and maternal vigilance in identifying TKUCs before delivery. Despite diagnostic challenges, heightened clinical awareness and timely intervention can contribute to favorable perinatal outcomes. Future research should aim to improve diagnostic accuracy and develop effective risk-stratification tools.