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Case Reports in Obstetrics and Gynecology
Volume 2012 (2012), Article ID 748614, 3 pages
http://dx.doi.org/10.1155/2012/748614
Case Report

A Rare Case of Antepartum Spontaneous Septostomy in a Monochorionic Diamniotic Twin Pregnancy

1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Foothills Medical Center, Calgary, AB, Canada T2N 2T9
2Department of Diagnostic Imaging, Foothills Medical Center, Calgary, AB, Canada T2N 2T9

Received 17 June 2012; Accepted 26 August 2012

Academic Editors: P. McGovern and E. Vaisbuch

Copyright © 2012 Rati Chadha et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Spontaneous septostomy in a monochorionic diamniotic twin pregnancy is a rare phenomenon. We present a case of monochorionic diamniotic twin pregnancy with an intact dividing membrane seen in the 1st half of the pregnancy. At 26 weeks, when she was assessed for preterm contractions, the dividing membrane was not documented, which suggested spontaneous septostomy. There had been no invasive procedures during the pregnancy. She subsequently delivered at 29 weeks, secondary to preterm labor. No dividing membrane was noticed at the time of caesarian section. Spontaneous septostomy can complicate the management of monochorionic diamniotic twins by creating a pseudomonoamniotic environment resulting in cord entanglement, and difficulty in the diagnosis and management of twin-twin transfusion syndrome. We believe that such a case should be managed as monochorionic monoamniotic twin gestation.