Abstract
Background
Patients requiring assisted reproductive techniques may have a higher rate of congenital malformations. Some rare complications of pregnancy might be related to such abnormalities. Torsions of the umbilical cord resulting in fetal death have previously been described exclusively in pregnancies following spontaneous conception.
Case
The case of 37 year old gravida I, para O woman with a twin pregnancy after intracytoplasmatic sperm injection and intrauterine death of one twin at approximately 30 weeks’ gestation is presented. The surviving twin was delivered by cesarean section at 31 weeks after spontaneous onset of labor and recurrent fetal bradycardia. The intraoperative situs showed that the demised twin had suffered from multiple umbilical cord torsions leading to intrauterine hypoperfusion.
Conclusion
Umbilical torsion leading to fetal death might represent a previously unrecognized complication in women requiring assisted reproductive techniques, but this problem is known to occur in pregnancies achieved by natural methods.
References
Kliman H. Intrauterine fetal death. 2006; August 10, 2006 [cited 2007 02.01.2007]; Available from: www.uptodateonline.com/utd.
Larson JD, Rayburn WF, Crosby S, Thurnau GR. Multiple nuchal cord entanglements and intrapartum complications. Am J Obstet Gynecol 1995;173:1228–31.
Streeter G. Weight, sitting height, head size, foot length, and menstrual age of the human embryo. Contr Embryol 1920;11:143–70.
Bakotic BW, Boyd T, Poppiti R, Pflueger S. Recurrent umbilical cord torsion leading to fetal death in 3 subsequent pregnancies: a case report and review of the literature. Arch Pathol Lab Med 2000;124:1352–5.
Ben-Arie A, Weissman A, Steinberg Y, Levy R, Hagay Z. Oligohydramnios, intrauterine growth retardation and fetal death due to umbilical cord torsion. Arch Gynecol Obstet 1995;256:159–61.
Hallak M, Pryde PG, Qureshi F, Johnson MP, Jacques SM, Evans MI. Constriction of the umbilical cord leading to fetal death. A report of three cases. J Reprod Med 1994;39:561–5.
Herman A, Zabow P, Segal M, Ron-el R, Bukovsky Y, Caspi E. Extremely large number of twists of the umbilical cord causing torsion and intrauterine fetal death. Int J Gynaecol Obstet 1991;35:165–7.
Lamont RF. Recent evidence associated with the condition of preterm prelabour rupture of the membranes. Curr Opin Obstet Gynecol 2003;15:91–9.
Bonilla-Musoles F, Machado LE, Osborne NG. Multiple congenital contractures (congenital multiple arthrogryposis). J Perinat Med 2002;30:99–104.
Hershkovitz R, Silberstein T, Sheiner E, Shoham-Vardi I, Holcberg G, Katz M, et al. Risk factors associated with true knots of the umbilical cord. Eur J Obstet Gynecol Reprod Biol 2001;98:36–9.
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Fleisch, M.C., Hoehn, T. Intrauterine fetal death after multiple umbilical cord torsion—complication of a twin pregnancy following assisted reproduction. J Assist Reprod Genet 25, 277–279 (2008). https://doi.org/10.1007/s10815-008-9227-0
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DOI: https://doi.org/10.1007/s10815-008-9227-0