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Growth restriction of the fetus has also been reported with a greater frequency
in fetuses with two vessel cords. Finally, initial studies did show an increase risk
of perinatal mortality, or fetal death, however the impact of other anomalies in
this data was unclear. These two complications, however, are difficult to study
secondary to the impact of the other anomalies seen with a two vessel cord. In
addition, this is a more common finding in twins, and again they are also at risk
for growth restriction and stillbirth. To be safe, consider fetal monitoring in the
last 4-6 weeks of pregnancy as well as growth scans through the third trimester.
If a two vessel cord is diagnosed, the first step is a detailed Level II genetic
ultrasound to examine for other anomalies. Particular attention should be paid
to the fetal heart and kidneys, since these are common areas for associated
malformations. If there are other abnormalities, or if a patient is higher risk, an
amniocentesis should be considered to rule out chromosome abnormalities, like
Down Syndrome. The fetal growth profile should be followed. Close third
trimester surveillance for stillbirth should also be undertaken as above. The vast
majority of cases, however, progress without incident resulting in a successful
pregnancy outcome.