title: Ultrasound to identify cord knotting in monoamniotic monochorionic twins.
abstract: This case report demonstrates the use of ultrasound and doppler flow in the management of mono-amniotic monochorionic (M/M) twins. M/M twinning is a rare but significant event. It is associated with high rates of fetal mortality, most commonly cited at anywhere from between 30% and 70%. A common cause of death is cord entanglement. The case presented is that of a 19-year-old gravida 1 at 30 weeks with M/M twins in which multiple cord knots were found by ultrasound color doppler flow after variable fetal heart rate decelerations occurred. This prompted a decision for immediate cesarean delivery with normal fetal outcomes. Improvements in perinatal imaging systems are therefore beneficial in the management of M/M twins.
authors.affiliation: Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33606, USA. adeutsch@hsc.usf.edu
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Deutsch
authors.forename: Evan
authors.initials: E
authors.lastname: Miller
authors.forename: William N
authors.initials: WN
authors.lastname: Spellacy
authors.forename: Rhonda
authors.initials: R
authors.lastname: Mabry
mesh_terms: D000328:Adult; D000650:Amnion / Q000000981:diagnostic imaging* / Q000473:pathology; D002585:Cesarean Section; D002823:Chorion / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005865:Gestational Age; D006801:Humans; D050498:Live Birth; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D014427:Twins; D016216:Ultrasonography, Prenatal; D014470:Umbilical Cord / Q000000981:diagnostic imaging* / Q000473:pathology