[Umbilical cord complications in twin pregnancies]

The postpartum umbilical cord examination can provide a lot of significant information concerning discordant twin growth or reasons of intrauterine death of one or all the fetuses. The aim of this study was the postpartum assessment of umbilical cords in twin pregnancies.

The examination material consisted placentas coming from 110 twin pregnancies. The analysis concerned the assessment of placenta types, the umbilical cords attachment place and also the twins birth weight.

Basing on the studies of placentas coming from 110 twin pregnancies 76 (69.0%) dichorionic and 34 (31.0%) monochorionic placentas were found. Among dichorionic, 40 (53%) separated and 36 (47%) fused placentas were observed. Among monochorionic 31 (91%) diamniotic and 3 (9.0%) monoamniotic placentas were present. Abnormal umbilical insertion to placenta was most frequently observed in monochorionic pregnancies: in diamniotic--marginal insertion in 21.2%, velamentous insertion in 15.9%, and in monoamniotic--equally 33.3%. In dichorionic pregnancies, for fused placentas--marginal in 8.7%, velamentous in 9.1%, and for separated--5.6% and 3.1%.

The abnormal umbilical cord insertions to the placenta was most frequently found in monochorionic pregnancies. Among pairs of twin born with body weight discordance, the abnormal umbilical cord insertion was more frequently found in the case of the smaller newborn.