Monday, July 30, 2012

Shared

A 30 year old G1P0 has division of a single fertilized oocyte at 10 days post fertilization. Ultrasound in the first trimester shows twins, a single placental disk, and no intertwin membrane. Instillation of dye in the amniotic sac of one twin is performed and amniotic fluid drawn from near the second twin has dye.


She is admitted at 26 weeks pregnancy and will stay as an inpatient until 32 weeks when she will get a C-section. When you ask why, the attending says, "We have to do daily fetal monitoring, look for cord knots on ultrasound, and check Doppler velocitometry."


Challenge: What is the concern, which is unique to this type of pregnancy?


Image shown under Fair Use.

3 comments:

Dark Angel said...

Dear dr Craig,
How are you doing? I'm a big fan of your blog So I created a facebook page for it
https://www.facebook.com/Clinical.Cases
it has over 2800 fans and I want to make you an admin of this page "Clinical Cases"
Also I'm the admin of the largest medical page on facebook
https://www.facebook.com/All.doctors that has over 123 thousands doctors and I'm ready to publish your cases so all members share in solving them.
All what I want in return is that you place an "adsense" banner at the top of your page. it's dimensions are 728*90 and It's very easy to implement to your website . If you agreed I'll send you the html code of the banner and the instructions to use it.
email me
mazinez2@gmail.com

tree said...

cord entanglement!

Craig Chen said...

yup, cord entanglement. Dark Angel - thanks for the offer. I don't have time right now for more things, but I like your facebook groups :)
-
Shared

Monoamniotic, monochorionic twins are rare but have a high risk of fetal complications including cord entanglement which can lead to cord compression, fetal injury, and death.

Source: UpToDate.