title: Death of one twin followed by extremely variable flow velocity waveforms in the surviving fetus.
abstract: Intrauterine death of one fetus after the second trimester in a twin pregnancy, with continuation of the pregnancy is a rare complication. The risks of morbidity and mortality for the surviving fetus are high. A 32-year-old woman was admitted to the antenatal ward at 27 weeks gestation because of intrauterine death of one twin. During the first 24 h after the death of one twin, Doppler ultrasound assessment showed a remarkable variability in flow velocity waveforms in the umbilical artery of the surviving fetus. Changes from reversed to normal end-diastolic flow velocities were recorded within 6 min. These findings are explained by twin-to-twin transfusion due to intravascular blood pressure changes, or by release of vasoactive substances by the dead fetus.
authors.affiliation: Department of Obstetrics and Gynaecology, State University Hospital, Groningen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Lander
authors.forename: H
authors.initials: H
authors.lastname: Oosterhof
authors.forename: J G
authors.initials: JG
authors.lastname: Aarnoudse
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D015148:Cardiotocography; D002585:Cesarean Section; D005260:Female; D005313:Fetal Death / Q000150:complications* / Q000000981:diagnostic imaging; D005333:Fetus / Q000098:blood supply*; D006801:Humans; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D007752:Obstetric Labor, Premature / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D011263:Pregnancy Trimester, Third; D011272:Pregnancy, Multiple; D014427:Twins; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000502:physiology*