Document Detail

Two cases with dichorionic diamniotic triplet pregnancy and early cord entanglement.
MedLine Citation:
PMID:  11665299     Owner:  NLM     Status:  MEDLINE    
Within a period of 6 years (1994-99) we registered 29 triplet deliveries out of a total of 13,969 hospital deliveries (0.02%). Since there is limited information about specific problems of chorionicity in triplet pregnancies, we analysed the 29 cases according to origin of pregnancy and chorionicity. We here report on two cases with a high risk according to chorionicity with dichorionic (DC) diamniotic (DA) triplet pregnancies. Out of the two cases, one pregnancy was spontaneous and one originated after in-vitro fertilization. In both pregnancies, cord entanglement was detected early in pregnancy (at 10 and 15 weeks) by color Doppler velocimetry demonstrating different heart rates within the segment of the entangled umbilical branches. The pregnancies were followed by documenting fetal behavior and color Doppler velocimetry of umbilical and fetal arteries at weekly intervals. In both cases, a primary Cesarean section was performed after detection of lung maturity. In the first case, one of the MA triplets had a transposition of the great arteries and abnormal lung vein drainage, which was the reason for neonatal death three weeks postnatally. Although early cord entanglement has been described in MA twins, this series demonstrates that it can as well be demonstrated in MA triplets. The early detection allows for extensive surveillance of the a priori high risk triplet pregnancy.
A E Merién; J van Eyck; B Arabin
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Twin research : the official journal of the International Society for Twin Studies     Volume:  4     ISSN:  1369-0523     ISO Abbreviation:  Twin Res     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-10-22     Completed Date:  2001-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9815819     Medline TA:  Twin Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  219-22     Citation Subset:  IM    
Department of Perinatology, Isala (Sophia) Hospital 8025 AB Zwolle, The Netherlands.
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MeSH Terms
Abnormalities, Multiple / ultrasonography
Amnion / ultrasonography*
Chorion / ultrasonography*
Diseases in Twins / diagnosis
Fatal Outcome
Fetal Diseases / ultrasonography
Placenta / radiography,  ultrasonography
Pregnancy, High-Risk
Twins, Dizygotic
Twins, Monozygotic
Ultrasonography, Prenatal*
Umbilical Cord / ultrasonography*

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