Eserdag S, Zulfikaroglu E, Ozer A
Department of Obstetrics and Gynecology, Ankara Dr. Zekai Tahir Burak Women Health Teaching and Research Hospital, Ankara, Turkey.
Bratisl Lek Listy. 2010;111(12):673-5.
Monochorionic monoamniotic twin gestations have been associated with perinatal mortality rates as high as 28% to 47%. Umbilical cord entanglements and knots, twin-to-twin transfusion syndrome, congenital anomalies, prematurity and intertwin locking during labor are responsible for their high perinatal morbidity and mortality. We report here two cases of cord entanglements: One of them was associated with twin-to-twin transfusion syndrome with gross vascular anastomoses and a massive cord entanglement. The other one was associated with cesarean section due to dystocia of cord entanglement of the second fetus after vaginal birth of the first one. There is still no consensus in literature for the management and the mode of delivery of these rarely encountered cases (Fig. 3, Ref. 13).
单绒毛膜单羊膜囊双胎妊娠的围产儿死亡率高达28%至47%。脐带缠绕、打结、双胎输血综合征、先天性畸形、早产以及分娩时双胎相互嵌顿是导致其围产儿发病率和死亡率高的原因。我们在此报告两例脐带缠绕病例：其中一例与伴有粗大血管吻合和严重脐带缠绕的双胎输血综合征相关。另一例是在第一胎儿经阴道分娩后，因第二胎儿脐带缠绕难产而行剖宫产。对于这些罕见病例的处理和分娩方式，文献中仍未达成共识（图3，参考文献13）。
