Monochorionic Diamniotic Twins with Bordering Cord Insertions: Images and Outcome

Area of Science:

• Perinatology
• Maternal-Fetal Medicine
• Obstetrics

Background:

• Twin pregnancies, especially monochorionic diamniotic (MCDA) types, are linked to increased perinatal mortality.
• Placental abnormalities are more prevalent in twin gestations compared to singleton pregnancies.
• Vascular anastomoses in MCDA pregnancies can lead to severe complications like Twin-to-Twin Transfusion Syndrome (TTTS).

Purpose of the Study:

• To report a rare case of MCDA twin pregnancy.
• To describe a case of Twin-to-Twin Transfusion Syndrome (TTTS) grade 1.
• To highlight unusual bordering umbilical cord insertions in the context of TTTS.

Main Methods:

• Case report presentation.
• Review of obstetric and perinatal data for a twin pregnancy.
• Description of placental and umbilical cord anatomy.

Main Results:

• A rare case of MCDA twin pregnancy with TTTS grade 1 was identified.
• The umbilical cords exhibited bordering insertions, a deviation from the typical distant insertions seen in TTTS.
• This finding presents a unique anatomical variation in a complicated twin pregnancy.

Conclusions:

• Bordering umbilical cord insertions can occur in MCDA twin pregnancies complicated by TTTS.
• This case expands the understanding of anatomical variations in TTTS.
• Further investigation into the implications of cord insertion variations in twin pregnancies is warranted.