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Intrauterine growth restriction in monochorionic twin pregnancy complicated with velamentous placen-ta:report of one case
Author(s): Chen Change
Pages: 567-
570
Year: 2016
Issue:
8
Journal: New Chinese Medicine
Keyword: Monochorionic twin pregnancy; Intrauterine growth restriction; Velamentous insertion; Ultrasonic diagnosis;
Abstract: Monochorionic twin pregnancy complicated with velamentous insertion of umbilical cord is rarely reported in clinical practice.In this article,we reported one case of fetal growth restriction in monochori-onic twin pregnancy complicated with velamentous insertion of umbilical cord.The pregnant woman experienced menolipsis for 35 weeks and inferior abdominal pain for 5 h.She was diagnosed with fetal growth restriction in twin pregnancy by repeated B-ultrasound in another hospital and upon admission to our hospital.No abnormality of umbilical cord was reported.After active fetal protection therapy and nutrition enrichment for 2 weeks,B-ul-trasound revealed the signs of fetal growth restriction,oligohydramnios of the second fetus and absent end-dias-tolic flow of umbilical artery.The possibility of umbilical cord compression of the twins and placental flow ab-normality was not excluded.She delivered two female infants and placenta with velamentous insertion by caesar-ean section in the Department of Emergency.Two umbilical cords were aligned and adhered to the fetal mem-brane in V-shape.Two female infants had low-and extremely-low birth weight.After ineffective non-invasive ventilation,the infant with extremely-low birth weight died from MODS at the 3 rd day after hospitalization.The woman and the other infant were recovered and discharged at 20 and 10 days after hospitalization.This case prompts that the growth and development of the twins and the changes of amniotic fluid quantity should be closely monitored by prenatal ultrasound.The insertion point of umbilical cord,umbilical artery blood flow and alternative parameters should be explicitly observed to provide more evidence for prenatal consultation and clinical decision-making and improve the clinical prognosis of monochorionic twin pregnancy during perinatal period.
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