title: Presence of an umbilical artery notch in monochorionic/monoamniotic twins.
abstract: OBJECTIVE
  To examine the association between an umbilical artery notch and fetal deterioration in monochorionic/monoamniotic (MC/MA) twins.
  
  
  METHODS
  Six MC/MA twin pregnancies were admitted at 24-28 weeks of gestation for close fetal surveillance until elective delivery at 32 weeks or earlier in the presence of signs of fetal deterioration. Ultrasound (US) examinations were performed twice weekly. The presence of cord entanglement, umbilical artery notch, abnormal Doppler parameters, a non-reassuring fetal heart rate pattern, or an abnormal fetal biophysical profile were evaluated.
  
  
  RESULTS
  Umbilical cord entanglement was observed on US in all pregnancies. The presence of an umbilical artery notch was noted in four out of six pregnancies and in two of them an umbilical artery notch was seen in both twins. The umbilical artery pulsatility index was normal in all fetuses. Doppler parameters of the middle cerebral artery and ductus venosus, fetal biophysical profile and fetal heart rate monitoring remained normal until delivery in all pregnancies. All neonates experienced morbidity related to prematurity; however, all were discharged home in good condition.
  
  
  CONCLUSIONS
  The presence of an umbilical artery notch and cord entanglement, without other signs of fetal deterioration, are not indicative of an adverse perinatal outcome.
authors: Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Md., and Detroit, Mich., USA.
authors: Alma
authors: A
authors: Aurioles-Garibay
authors: Edgar
authors: E
authors: Hernandez-Andrade
authors: Roberto
authors: R
authors: Romero
authors: Maynor
authors: M
authors: Garcia
authors: Faisal
authors: F
authors: Qureshi
authors: Suzanne M
authors: SM
authors: Jacques
authors: Hyunyoung
authors: H
authors: Ahn
authors: Lami
authors: L
authors: Yeo
authors: Tinnakorn
authors: T
authors: Chaiworapongsa
authors: Sonia S
authors: SS
authors: Hassan
mesh_terms: D005260:Female; D006801:Humans; D053589:Nuchal Cord / Q000150:complications / Q000000981:diagnostic imaging; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D059285:Pregnancy, Twin; D011673:Pulsatile Flow; D014463:Ultrasonography; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000473:pathology* / Q000502:physiology