title: [Notch in the umbilical artery Doppler profile in umbilical cord compression in a twin].
abstract: Monoamniotic twins have a mortality rate of up to 50%, mainly due to umbilical cord accidents, e.g. true knots. Because of the rarity of monoamniotic twin gestation, few data are presently available on the optimal management of these gestations. Some authors recommend delivery at 32 weeks of gestation, while others state that the risk of cord accidents declines with advancing gestational age, thus questioning the usefulness of routine delivery at 32 weeks. It is possible nowadays to obtain an impression of the fetal blood supply by Doppler sonography. In our case, Doppler sonographic evaluation showed a notch in the umbilical artery in the twin, who later developed a pathological CTG requiring delivery at 28 weeks of gestation. Both fetuses are liveborn and developed normally. Our case shows that a notch in the umbilical artery could be an indication of umbilical cord compression and that attention should be paid to it in monoamniotic twin gestation.
authors.affiliation: Frauenklinik, Universitätsklinikum Benjamin Franklin Freie Universität Berlin.
authors.forename: M
authors.initials: M
authors.lastname: Entezami
authors.forename: V
authors.initials: V
authors.lastname: Ragosch
authors.forename: H
authors.initials: H
authors.lastname: Hopp
authors.forename: H K
authors.initials: HK
authors.lastname: Weitzel
authors.forename: S
authors.initials: S
authors.lastname: Runkel
mesh_terms: D000328:Adult; D001238:Asphyxia Neonatorum / Q000000981:diagnostic imaging*; D002585:Cesarean Section; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D004200:Diseases in Twins; D005260:Female; D005865:Gestational Age; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D014430:Twins, Monozygotic; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*; D014655:Vascular Resistance / Q000502:physiology
vernacular_title: Der Notch im Nabelarteriendopplerprofil bei Nabelschnurkompression eines Zwillings.