title: Pseudomonoamniotic Pregnancy: Case Report and Review of Etiologic Considerations.
abstract: Pseudomonoamniotic gestations are increasingly recognized through sonographic surveillance of monochorionic twins, though etiologic factors remain undefined. We present a case of spontaneous pseudomonoamniotic twins and propose umbilical cord insertion proximity as a sonographic marker. Systematic review of the literature was performed and additional cases with similar findings were noted. Approximately 75% of reported cases (28/37) were deemed spontaneous and several included short inter-cord distances. Shunting of blood away from the membranes in the region between the cord insertions may be responsible for membrane rupture. Further investigation is needed into short inter-cord distance as a marker for monochorionic twins at risk to become a pseudomonoamniotic gestation.
authors.affiliation: a Division of Maternal-Fetal Medicine , Indiana University School of Medicine , Indianapolis , Indiana , USA.
authors.forename: Avinash S
authors.initials: AS
authors.lastname: Patil
authors.affiliation: b Department of Obstetrics & Gynecology , Indiana University School of Medicine , Indianapolis , Indiana , USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Martin
authors.affiliation: c Indiana University School of Medicine , Indianapolis , Indiana , USA.
authors.forename: Katharine
authors.initials: K
authors.lastname: Tsukahara
authors.affiliation: c Indiana University School of Medicine , Indianapolis , Indiana , USA.
authors.forename: Anja
authors.initials: A
authors.lastname: Skljarevski
authors.affiliation: c Indiana University School of Medicine , Indianapolis , Indiana , USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Miller
authors.affiliation: b Department of Obstetrics & Gynecology , Indiana University School of Medicine , Indianapolis , Indiana , USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Towns
authors.affiliation: a Division of Maternal-Fetal Medicine , Indiana University School of Medicine , Indianapolis , Indiana , USA.
authors.forename: Frank P
authors.initials: FP
authors.lastname: Schubert
mesh_terms: D000328:Adult; D000650:Amnion / Q000002:abnormalities*; D002823:Chorion; D004200:Diseases in Twins; D005260:Female; D006801:Humans; D011247:Pregnancy; D059285:Pregnancy, Twin; D014430:Twins, Monozygotic; D014470:Umbilical Cord / Q000473:pathology*
keywords: monochorionic; pseudomonoamniotic; twins