Radswiki T, Fahrenhorst-Jones T, Elfeky M, et al. Umbilical cord entanglement. Reference article, Radiopaedia.org (Accessed on 14 Dec 2024) https://doi.org/10.53347/rID-14570
Umbilical cord entanglement is a feature which can mean either one or more loops of the umbilical cord encircling any part of the fetal body or two umbilical cords becoming entangled with each other 3. In the latter situation, it is a classical feature of a monochorionic-monoamniotic twin pregnancy. Very rarely it can occur in a diamniotic twinning with disruption of the dividing membrane either naturally or secondary to a procedure such as an amniocentesis.
It is often considered a part of normal early fetal development and can be a common finding in the 1st trimester. It has been described in over 70% of MCMA twin pregnancies and it is less of a problem in very early pregnancy.
Radiographic features
Ultrasound
If an associated tightening/knot is a concern Doppler assessment can be carried out.
Cord entanglement itself is rarely a problem but an associated tightening leading to an umbilical cord knot is a concern where arterial compromise can cause catastrophic complications.
1. Larson JD, Rayburn WF, Crosby S et-al. Multiple nuchal cord entanglements and intrapartum complications. Am. J. Obstet. Gynecol. 1995;173 (4): 1228-31. Am. J. Obstet. Gynecol. (link) - Pubmed citation
2. Arabin B, Laurini RN, Van eyck J. Early prenatal diagnosis of cord entanglement in monoamniotic multiple pregnancies. Ultrasound Obstet Gynecol. 1999;13 (3): 181-6. doi:10.1046/j.1469-0705.1999.13030181.x - Pubmed citation
3. Dias T, Mahsud-dornan S, Bhide A et-al. Cord entanglement and perinatal outcome in monoamniotic twin pregnancies. Ultrasound Obstet Gynecol. 2010;35 (2): 201-4. doi:10.1002/uog.7501 - Pubmed citation
4. Rodeck CH, Whittle MJ. Fetal medicine, basic science and clinical practice. Elsevier Health Sciences. (2008) ISBN:0443104085. Read it at Google Books - Find it at Amazon
6. Tepper R, Kidron D, Aviram R et-al. High incidence of cord entanglement during early pregnancy detected by three-dimensional sonography. Am J Perinatol. 2009;26 (5): 379-82. doi:10.1055/s-0028-1110090 - Pubmed citation
Unable to process the form. Check for errors and try again.