Agenesis of the ductus venosus in a case of monochorionic twins which mimics twin-twin transfusion syndrome.
We describe a pair of monochorionic twins with clinical manifestation of twin-twin transfusion syndrome, including discordant fetal growth, hydrops of the larger twin, and the 'stuck twin' phenomenon of the smaller twin. In the hydropic twin, we found agenesis of the ductus venosus and an abnormal umbilical vein draining directly into the inferior vena cava. There was also marked enlargement of the right atrium, representing the volume overload on it. We believe that the agenesis of the ductus venosus in the larger twin may have contributed to the 'unbalanced shunting' between the monochorionic twins. This then led to a clinical picture mimicking that seen in the authentic twin-twin transfusion syndrome.
Shih
J C
JC
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei.
Shyu
M K
MK
Hsieh
M H
MH
Yang
J H
JH
Huang
S F
SF
Lin
G J
GJ
Hsieh
F J
FJ
D000328:Adult; D003937:Diagnosis, Differential; D004200:Diseases in Twins / Q000175:diagnosis*; D005260:Female; D005313:Fetal Death; D005330:Fetofetal Transfusion / Q000175:diagnosis*; D006801:Humans; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D014430:Twins, Monozygotic; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014471:Umbilical Veins / Q000000981:diagnostic imaging; D014682:Vena Cava, Inferior / Q000002:abnormalities*