The "Mass of Cords" in Mono-Mono Twins

Monochorionic-monoamniotic twins share a single amniotic sac, placing them at extreme risk for umbilical cord entanglement.

On B-mode, this appears as an intricate "mass of cords" between the fetuses. Color and pulsed Doppler unequivocally confirm entanglement by revealing two distinct fetal heart rate waveforms within the exact same spectral Doppler display.

Clinical Bottom Line: Use pulsed Doppler to document two unique fetal heart rates within the cord mass to confidently diagnose entanglement and guide intensive fetal surveillance.