The Umbilical Cord and Complications of Twin Gestations

作     者：Aurianne Van Grambezen Patricia Steenhaut Bénédicte Van Grambezen Frédéric Debieve Pierre Bernard Corinne Hubinont 

作者机构：Department of ObstetricsSaint Luc University HospitalBrussels B-1200Belgium Department of NeonatologySaint Luc University HospitalBrussels B-1200Belgium. 

出 版 物：《Maternal-Fetal Medicine》 (母胎医学杂志（英文）)

年 卷 期：2022年第4卷第4期

页      面：276-285页

学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学] 

主　　题：Pregnancy twin Chorionicity Cord entanglement Twin reversed arterial perfusion sequence Umbilical cord Vasa previa Velamentous cord insertion 

摘      要：The rate of twin pregnancies has increased over the last decades, largely because of the ongoing development of assisted reproductive technology and increased maternal age at childbearing. Twins have a higher risk of adverse outcomes during pregnancy and the perinatal period. The prevalence of umbilical cord abnormalities is higher for twin pregnancies compared with singleton pregnancies. Some of these abnormalities are nonspecific to twinning and can also be found in singleton gestations (such as velamentous cord insertion, vasa previa, and single umbilical artery). Other abnormalities are associated with monochorionic twins, such as umbilical cord entanglement, and umbilical proximate cord insertion. Most of these abnormalities can be detected by ultrasound evaluation. The early and accurate ultrasound diagnosis of chorionicity, amnionicity, and placental and umbilical cord characteristics is crucial if we are to predict the risk of complications and to determine the best management for twin pregnancies. Histopathological examination of the placenta and umbilical cord after delivery can help to confirm prenatal diagnosis and to provide a better understanding of the physiopathology of their abnormalities. The aim of this review was to emphasize the role that the umbilical cord plays in twin complications and to describe the management of these high-risk pregnancies.