The presence of the umbilical cord in the fetal neck is a frequent condition. Up to one in 6 full-term pregnancies may present with the umbilical cord with a loop around the fetal neck. It is clear that the number of loops of the cord is a risk factor associated with perinatal morbidity and mortality. Indeed, the finding of 2 or 3 cord loops is the subject of some reports, however the presence of 4 or more loops is a rather rare finding in the literature. The case of a patient treated at the Fetal Maternal Medicine Unit of the Fundación Santa Fe University Hospital in Bogota DC Colombia is presented. A pregnant woman in her first pregnancy. During ultrasound examination, the umbilical cord wound 4 times around the fetus's neck was found incidentally with Mode B ultrasound, Colour Doppler. GE Voluson E8 team. The patient due to decreased fetal movements and uterine contractions was hospitalised and a Caesarean section was performed and a 2425-gram newborn was obtained at 36 weeks. She was transferred to the low birth weight newborn unit. She evolved without complications. The rareness of the case stands out, the possibility of making a prenatal diagnosis that allows close surveillance with the possibility of preventing the risk of severe complications and perinatal death. The finding of high-order cord circulars (3 or more) should alert the perinatal care group. The time for the termination of the pregnancy will depend on the particular conditions of each case. Supporting information can be found in the online version of this abstract Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.