Paper Title: Umbilical cord torsion with intrauterine fetal death in a multipara with two previous Caesarean sections: A Case Report
Authors: Abam D.S, Eli S. , Kalio D.G.B, NWOSU C.C
Background: Umbilical cord torsion and other cord accidents are causes of perinatal morbidity and mortality. Umbilical cord torsion accounts for a 4-fold increase in perinatal death. Aim: The aim of this paper is to present a rare clinical entity and create awareness on its management modalities. Case Report: Mrs. P.O. a 39 year old G4 para 2+1 (2 alive) with two previous caesarean sections presented at the antenatal clinic at 36 weeks gestation with a 2-day history of absence of fetal movement. Intrauterine fetal demise was confirmed via a sonogram. The antenatal period was before now uneventful. She was diagnosed with an unexplained intrauterine fetal death; and subsequently had an elective repeat caesarean section. At surgery, the fetal death was strongly suspected to have resulted from torsion of the umbilical cord. Her post-operative period was uneventful. She was discharged on the 7th post-operative day. Conclusion Due to the emotional pain expressed by parturients with antenatal fetal death, mostly in those in whom the cause of death is uncertain and unexpected, we recommend that more steps be employed in antepartum fetal surveillance, including the use of Doppler, which may pick up some vascular disorders that may increase the predictability of intrauterine fetal death. However, in resource poor countries the acquisition of these tools may still seem far-fetched.