Downloaded from http://fn.bmj.com/ on November 4, 2014 - Published by group.bmj.com
Original article
IMAGES IN NEONATAL MEDICINE
Cord entanglement Monoamniotic twins were delivered at 33 weeks by elective Caesarean section. At operation, markedly entangled umbilical cords with several coils, but no signs of constrictions, were observed (figure 1). Both twins and the mother had favourable clinical outcomes. The cord entanglement was not identifiable on scan before delivery. Monoamniotic pregnancies account from 1% to 5% of all monozygotic conceptions. High perinatal mortality is observed due to congenital anomalies, conjoined twins, twin-reversed perfusion sequence and twin–twin transfusion syndrome.1 2 Cord entanglement increases the risk of sudden cord accidents and may be prevented by planned preterm delivery.3 Silvia Salvi,1 Sara De Carolis,1 Serafina Garofalo,1 Gelsomina Del Sordo,1 Cristina Garufi,2 Maria Pia De Carolis3 1
Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, Rome, Italy University of Rome “La Sapienza”, Sant’Andrea Hospital, Rome, Italy 3 Department of Paediatrics, Division of Neonatology, Catholic University of Sacred Heart, Rome, Italy 2
Correspondence to Dr Maria Pia De Carolis, Department of Paediatrics, Division of Neonatology, Policlinico A. Gemelli, Catholic University of Sacred Heart, Largo Gemelli 8, Rome 00168, Italy; [email protected]
Figure 1
Competing interests None.
Arch Dis Child Fetal Neonatal Ed 2014;99:F457. doi:10.1136/archdischild-2013-305861
Patient consent Obtained. Provenance and peer review Not commissioned; internally peer reviewed.
REFERENCES 1
2
To cite Salvi S, De Carolis S, Garofalo S, et al. Arch Dis Child Fetal Neonatal Ed 2014;99:F457. Received 17 December 2013 Revised 22 March 2014 Accepted 30 March 2014 Published Online First 19 April 2014
Umbilical cord entanglement at birth.
3
Rossi AC, Prefumo F. Impact of cord entanglement on perinatal outcome of monoamniotic twins: a systematic review of the literature. Ultrasound Obstet Gynecol 2013;41:131–5. Dias T, Mahsud-Dornan S, Bhide A, et al. Cord entanglement and perinatal outcome in monoamniotic twin pregnancies. Ultrasound Obstet Gynecol 2010;35:201–4. Lewi L. Cord entanglement in monoamniotic twins: does it really matter? Ultrasound Obstet Gynecol 2010;35:139–41.
Chan E, et al. Arch Dis Child Fetal Neonatal Ed 2014;99:F451–F457. doi:10.1136/archdischild-2014-306124
F457
Downloaded from http://fn.bmj.com/ on November 4, 2014 - Published by group.bmj.com
Cord entanglement Silvia Salvi, Sara De Carolis, Serafina Garofalo, Gelsomina Del Sordo, Cristina Garufi and Maria Pia De Carolis Arch Dis Child Fetal Neonatal Ed 2014 99: F457 originally published online April 19, 2014
doi: 10.1136/archdischild-2013-305861 Updated information and services can be found at: http://fn.bmj.com/content/99/6/F457
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This article cites 3 articles, 0 of which you can access for free at: http://fn.bmj.com/content/99/6/F457#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Articles on similar topics can be found in the following collections Competing interests (ethics) (78) Epidemiologic studies (839) Journalology (86) Pregnancy (1469) Reproductive medicine (1387)
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
Original article
IMAGES IN NEONATAL MEDICINE
Cord entanglement Monoamniotic twins were delivered at 33 weeks by elective Caesarean section. At operation, markedly entangled umbilical cords with several coils, but no signs of constrictions, were observed (figure 1). Both twins and the mother had favourable clinical outcomes. The cord entanglement was not identifiable on scan before delivery. Monoamniotic pregnancies account from 1% to 5% of all monozygotic conceptions. High perinatal mortality is observed due to congenital anomalies, conjoined twins, twin-reversed perfusion sequence and twin–twin transfusion syndrome.1 2 Cord entanglement increases the risk of sudden cord accidents and may be prevented by planned preterm delivery.3 Silvia Salvi,1 Sara De Carolis,1 Serafina Garofalo,1 Gelsomina Del Sordo,1 Cristina Garufi,2 Maria Pia De Carolis3 1
Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, Rome, Italy University of Rome “La Sapienza”, Sant’Andrea Hospital, Rome, Italy 3 Department of Paediatrics, Division of Neonatology, Catholic University of Sacred Heart, Rome, Italy 2
Correspondence to Dr Maria Pia De Carolis, Department of Paediatrics, Division of Neonatology, Policlinico A. Gemelli, Catholic University of Sacred Heart, Largo Gemelli 8, Rome 00168, Italy; [email protected]
Figure 1
Competing interests None.
Arch Dis Child Fetal Neonatal Ed 2014;99:F457. doi:10.1136/archdischild-2013-305861
Patient consent Obtained. Provenance and peer review Not commissioned; internally peer reviewed.
REFERENCES 1
2
To cite Salvi S, De Carolis S, Garofalo S, et al. Arch Dis Child Fetal Neonatal Ed 2014;99:F457. Received 17 December 2013 Revised 22 March 2014 Accepted 30 March 2014 Published Online First 19 April 2014
Umbilical cord entanglement at birth.
3
Rossi AC, Prefumo F. Impact of cord entanglement on perinatal outcome of monoamniotic twins: a systematic review of the literature. Ultrasound Obstet Gynecol 2013;41:131–5. Dias T, Mahsud-Dornan S, Bhide A, et al. Cord entanglement and perinatal outcome in monoamniotic twin pregnancies. Ultrasound Obstet Gynecol 2010;35:201–4. Lewi L. Cord entanglement in monoamniotic twins: does it really matter? Ultrasound Obstet Gynecol 2010;35:139–41.
Chan E, et al. Arch Dis Child Fetal Neonatal Ed 2014;99:F451–F457. doi:10.1136/archdischild-2014-306124
F457
Downloaded from http://fn.bmj.com/ on November 4, 2014 - Published by group.bmj.com
Cord entanglement Silvia Salvi, Sara De Carolis, Serafina Garofalo, Gelsomina Del Sordo, Cristina Garufi and Maria Pia De Carolis Arch Dis Child Fetal Neonatal Ed 2014 99: F457 originally published online April 19, 2014
doi: 10.1136/archdischild-2013-305861 Updated information and services can be found at: http://fn.bmj.com/content/99/6/F457
These include:
References Email alerting service
Topic Collections
This article cites 3 articles, 0 of which you can access for free at: http://fn.bmj.com/content/99/6/F457#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Articles on similar topics can be found in the following collections Competing interests (ethics) (78) Epidemiologic studies (839) Journalology (86) Pregnancy (1469) Reproductive medicine (1387)
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
