title: Spontaneous remission of double pulsatile umbilical venous flow in twin-twin transfusion syndrome: a case report.
abstract: Double umbilical pulsatile venous flow is a rare event generally associated with fetal right heart failure. We observed, at 21 weeks' gestation, this venous flow pattern in a case of twin-twin transfusion syndrome occurring in the recipient twin affected by severe hydrops. In spite of a spontaneous remission of fetal hydrops at 30 weeks, the fetus died suddenly in utero, 2 weeks later. We hypothesized that this unexpected event was related to reversed acute twin-twin transfusion, and concluded that fetal hydrops remission in twin-twin transfusion syndrome must not be considered as a reassuring prognostic index but as an indication of the need for continuing biophysical monitoring.
authors.affiliation: Department of Gynecology and Obstetrics, University of Parma, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Gramellini
authors.forename: G
authors.initials: G
authors.lastname: Ludovici
authors.forename: Y
authors.initials: Y
authors.lastname: Paita
authors.forename: A
authors.initials: A
authors.lastname: Merialdi
authors.forename: E
authors.initials: E
authors.lastname: Vadora
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D005260:Female; D005313:Fetal Death; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005865:Gestational Age; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging / Q000503:physiopathology; D011247:Pregnancy; D011673:Pulsatile Flow; D012075:Remission, Spontaneous; D014430:Twins, Monozygotic; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014471:Umbilical Veins / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014682:Vena Cava, Inferior / Q000503:physiopathology