Knotted. Warning graphic!
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That's insane.
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@klaus umbilical cord knots are pretty common (1%) , and they occur in utero, usually when the fetus is small and can move around. Once the fetus is larger, there's less likelihood of that happening.
It's usually not a big deal because the knot is not so tight as to compromise blood flow to the fetus. If it is marginally tight, during labor, the knot can become compressed, compromising blood flow. If severe enough, it can cause fetal distress and require an emergent c-section.
I've seen many cords with knots in them, and a few with two knots. But never one with a double knot, let alone a double and a single knot.