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KMID : 0358420110540060304
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Korean Journal of Obstetrics and Gynecology
2011 Volume.54 No. 6 p.304 ~ p.307
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Antepartum spontaneous rupture of the intertwin-dividing membrane in monochorionic diamniotic twins; Nearly adhered cords
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OH Jeong-Eun
Bae Jin-Young
Hwang In-A
Kim Mi-Ju
Seong Won-Joon
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Abstract
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Umbilical cord entanglement has been reported to occur in monoamniotic twins. However, it can occur in diamnionic twins due to rupture of the intertwin-dividing membrane, and is a cause for concern. A 31-year-old nullipara visited our hospital at 28+3 weeks gestation. A monochorionic diamniotic twin gestation was diagnosed ultrasonographically by visualizing a thin intertwin-dividing membrane and a single placenta. A cesarean section was performed at 35+3 weeks gestation and concordant twin fetuses with entangled umbilical cords were delivered. Gross examination revealed a single placenta with a ruptured dividing membrane. Our case, along with the other cases, confirms that antepartum rupture of an intertwin-dividing membrane is a clinical condition that should be considered in all cases of monochorionic diamniotic twin. A careful inspection of the dividing membrane and each cord insertion site should be performed. Once the dividing membrane cannot be easily visualized, the possibility of antepartum rupture should be suspected.
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KEYWORD
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Amniotic membrane, Rupture, Spontaneous, Twins, Fetal cord entanglement
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