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Published on: September 5, 2011
Ultrasound to identify cord knotting in monoamniotic monochorionic twins
Aaron B Deutsch1, Evan Miller, William N Spellacy
1Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33606, USA. adeutsch@hsc.usf.edu
Abstract:
This case report demonstrates the use of ultrasound and doppler flow in the management of mono-amniotic monochorionic (M/M) twins. M/M twinning is a rare but significant event. It is associated with high rates of fetal mortality, most commonly cited at anywhere from between 30% and 70%. A common cause of death is cord entanglement. The case presented is that of a 19-year-old gravida 1 at 30 weeks with M/M twins in which multiple cord knots were found by ultrasound color doppler flow after variable fetal heart rate decelerations occurred. This prompted a decision for immediate cesarean delivery with normal fetal outcomes. Improvements in perinatal imaging systems are therefore beneficial in the management of M/M twins.
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