title: Cord entanglement of monochorionic diamniotic twins following spontaneous antepartum septostomy sonographically simulating a true knot of the umbilical cord.
abstract: Spontaneous antepartum septostomy occurring in monochorionic diamniotic twins is extremely rare. We present a case in which prenatal sonography at 26 weeks' gestation depicted a monochorionic diamniotic twin gestation with concordant fetal growth and findings suggestive of a true knot of the umbilical cord. At Cesarean delivery at 34 weeks' gestation, spontaneous antepartum septostomy with entanglement of the two separate umbilical cords was noted. This case suggests that the differential diagnosis of findings considered consistent with a true knot of the umbilical cord in monochorionic diamniotic twin gestations, should include spontaneous antepartum septostomy and umbilical cord entanglement.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, NY 11203-2098, USA. dmsherer@aol.com
authors.forename: D M
authors.initials: DM
authors.lastname: Sherer
authors.forename: C
authors.initials: C
authors.lastname: Bitton
authors.forename: R
authors.initials: R
authors.lastname: Stimphil
authors.forename: M
authors.initials: M
authors.lastname: Dalloul
authors.forename: F
authors.initials: F
authors.lastname: Khoury-Collado
authors.forename: O
authors.initials: O
authors.lastname: Abulafia
mesh_terms: D000293:Adolescent; D002585:Cesarean Section / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011272:Pregnancy, Multiple; D014430:Twins, Monozygotic; D016216:Ultrasonography, Prenatal / Q000592:standards; D014470:Umbilical Cord / Q000000981:diagnostic imaging*