Does a knot in the cord cause asphyxia?

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A baby was born at term with a true double knot in the cord wrapped around her neck. There was no perinatal asphyxia, and the baby did well. Is a knot in the cord an adequate explanation if a baby is asphyxiated at birth? A randomised controlled trial compared cutting the knotted cord with leaving it intact and found no difference in neonatal outcome (Sadan O et al. Am. J. Perinatol. 2007; 24: 61–4).

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