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Review article

Umbilical cord wrapping and enlargement in monochorionic monoamniotic twins with letal outcome

Dubravko Habek ; Croatian Catholic University Zagreb, Croatia
Ingrid Marton ; Clinical Department of Obstetrics and Gynecology, Sveti Duh University Hospital
Matija Prka ; Clinical Department of Obstetrics and Gynecology, Sveti Duh University Hospital
Ana Luetić ; Clinical Department of Obstetrics and Gynecology, Sveti Duh University Hospital
Krešimir Živković ; Clinical Department of Obstetrics and Gynecology, Sveti Duh University Hospital


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Abstract

We present the case of tapered umbilical cords in monoamniotic monocorial twins with late abortion as an outcome. A pregnant woman at the age of 38 had healthy course of her second pregnancy. In the 9th week of gestation, an monoamniotic monocorionic pregnancy was diagnosed by ultrasound. Early amniocentesis was done due to the older age of a mother. During the procedure an enlargement of the umbilical cord was discovered, and the wrapping of the two umbilical cords. Mosaic trisomy of the 21st chromosome was proved. In the 19 w + 3 d gest., negative heart beats were detected for both of fetuses. The induction of abortion was initiated by prostaglandin vaginal gel (dinoprost). There were no signs of maceration, the weights were 230 and 190 grams, with increased and wrapped umbilical cords. The pathohistological fi nding confi rmed monochorionic-monoamniotic twin pregnancy with a long and tightly knit umbilical cord with complete blood fl ow obstruction and no signs of fetal malformalities. Also, there were no clinical signs of fetal transfusion syndrome. It is probably that the umbilical cord of the second twin was hypoplastic and with more complications.

Keywords

umbilical cord; wrapping; monoamniotic monochorionic twins

Hrčak ID:

251764

URI

https://hrcak.srce.hr/251764

Publication date:

1.4.2017.

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