title: Intrauterine head entrapment of a second twin by a uterine synechia.
abstract: BACKGROUND
  Fetal head entrapment during delivery is a rare occurrence in modern obstetrics. We present a case of intrauterine head entrapment of a second twin by a uterine synechia diagnosed by ultrasound and subsequent complications that occurred.
  
  
  METHODS
  A woman with a twin intrauterine pregnancy presented at 19 weeks for evaluation of a shortened cervix. Ultrasound examination demonstrated fetal head entrapment of twin B by a uterine synechia, as well as intrauterine growth restriction (IUGR). The patient experienced preterm premature rupture of membranes at 24 weeks' gestation and underwent a cesarean delivery for a nonreassuring fetal heart rate tracing of twin B, with findings of a constricting band of fibrous tissue around the neck of twin B.
  
  
  CONCLUSIONS
  Uterine synechia might cause intrauterine head entrapment and IUGR.
authors.affiliation: Division of Maternal-Fetal Medicine, Georgetown University Hospital, Washington, DC 20007, USA. deering95@hotmail.com
authors.forename: Shad H
authors.initials: SH
authors.lastname: Deering
authors.forename: Jessica
authors.initials: J
authors.lastname: Heller
authors.forename: Craig
authors.initials: C
authors.lastname: Winkel
authors.forename: Helain J
authors.initials: HJ
authors.lastname: Landy
mesh_terms: D000328:Adult; D002585:Cesarean Section; D003937:Diagnosis, Differential; D005260:Female; D005307:Fertilization in Vitro; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D011247:Pregnancy; D011272:Pregnancy, Multiple; D014427:Twins; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000002:abnormalities* / Q000000981:diagnostic imaging