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Umbilical cord entanglement has been reported to occur in monoamniotic twins. However, it can occur in diamnionic twins due to rupture of the intertwin-dividing membrane, and is a cause for concern. A 31-year-old nullipara visited our hospital at 28+3 weeks gestation. A monochorionic diamniotic twin gestation was diagnosed ultrasonographically by visualizing a thin intertwin-dividing membrane and a single placenta. A cesarean section was performed at 35+3 weeks gestation and concordant twin fetuses with entangled umbilical cords were delivered. Gross examination revealed a single placenta with a ruptured dividing membrane. Our case, along with the other cases, confi rms that antepartum rupture of an intertwin-dividing membrane is a clinical condition that should be considered in all cases of monochorionic diamniotic twin. A careful inspection of the dividing membrane and each cord insertion site should be performed. Once the dividing membrane cannot be easily visualized, the possibility of antepartum rupture should be suspected.

Antepartum spontaneous rupture of the intertwin-dividing membrane in monochorionic diamniotic twins; Nearly adhered cords