Intrauterine fetal death after multiple umbilical cord torsion – complication of a twin pregnancy following assisted reproduction

The case of 37 year old primagravida with a twin pregnancy after intracytoplasmatic sperm injection (ICSI) and intrauterine death of one twin at approximately 30 weeks of gestation is presented. The surviving twin was delivered by cesarean section at 31 gestational weeks after spontaneous onset of labor and recurrent fetal bradycardia. The intraoperative situs showed that the demised twin had suffered from multiple umbilical cord torsions leading to intrauterine hypoperfusion.