Recurrent Second Trimester Fetal Demise Caused by Hypercoiled Umbilical Cords

Umbilical cord flow impairment accounts for a majority of fetal vascular malperfusion (FVM). Hypercoiled umbilical cords are one cause of impaired fetal blood flow that may, in severe cases, result in intrauterine fetal demise (IUFD). Although the factors involved in umbilical cord patterning are incompletely understood, a limited number of reports have described recurrent intra-familial hypercoiling leading to death in the second trimester, suggesting a subset may have a genetic etiology.

Herein, we report two additional cases of recurrent second trimester IUFD secondary to FVM due to umbilical cord hypercoiling and briefly discuss all published cases.

Our cases add to a small, but growing, body of literature that suggests a genetic etiology to a subset of hypercoiled umbilical cords.