Third trimester intrauterine fetal death caused by complex cord entanglement

Umbilical cord entanglement occurs during early pregnancy. Typically, fetal asphyxia and demise because of umbilical cord entanglement is a unique characteristic of mono-amniotic twin pregnancies. We describe a case of a woman in late pregnancy that presented to medical consult at 36 weeks of amenorrhea because of the absence of fetal movements. The ultrasound found no fetal heartbeat and because the patient had two previous cesarean sections, another one was performed. We discovered a complex entanglement of the umbilical cord around the leg of the fetus that proved to be the cause of the fetal demise. Cord entanglement must be considered in cases of unexplained intrauterine fetal death. For all cases of intrauterine demise, it is important to look for marks of this condition around different parts of the body.