TITLE:
True Nodes of the Umbilical Cords of a Mono-Amniotic Pregnancy
AUTHORS:
Astou Coly Niassy, Ibrahim Rahadat, Aissatou Sankhare, Marie-Edouard Faye
KEYWORDS:
Twin Pregnancy, Fetal Death, Coiling
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.2,
February
24,
2023
ABSTRACT: The incidence of twin
pregnancies, has increased due to assisted reproductive technologies [1]. We
note a doubling between 1970 and 2010 from less than 8‰ to nearly 16‰ of
pregnancies (Pison et al., 2014;
Pison et al., 2015) in developed
countries [2] and 17‰ to 20‰ in sub-Saharan Africa. Monozygotic twins are the
product of fertilization of a single egg by a single sperm, with the egg
splitting into two within the first few days after fertilization. If the
division takes place after the 8th day, the pregnancy is
mono-chorionic mono-amniotic (less 1% of cases of monozygotic pregnancies) and
represents 1 in 30,000 pregnancies. It is the development of two fetuses within
the same amniotic sac, representing the rarest type of twin pregnancy (1% of
monozygotic twin pregnancies) but being the one with the highest fetal and maternal
morbidity. The main complication feared is coiling and knots of the umbilical
cords responsible for abnormal heartbeat, fetal suffering and eventual fetal
death. We report the case of in utero fetal death of twins from a mono choral
mono amniotic pregnancy secondary to knots and coiling of the cord in order to
discuss the diagnostic and therapeutic aspects.