Fetal death of one twin in a monochorionic pregnancy with twin-twin transfusion syndrome.
BACKGROUND
Twin-twin transfusion syndrome (TTTS) occurs in 5-30% of all monochorionic pregnancies. The mortality and morbidity rates are high and therapeutic options limited.


METHODS
TTTS in a monochorionic twin pregnancy was initially diagnosed by differences in amniotic fluid volume at 26 weeks. No signs of atrioventricular valve insufficiency or nonimmune hydrops fetalis were present in the recipient. Despite this, the recipient died in utero, whereupon the condition of the donor improved markedly. After spontaneous delivery at 30 weeks' gestation, coarctation of the umbilical cord at its insertion was observed in the recipient, probably secondary to severe torsion.


CONCLUSIONS
Unexpected obstetric events may occur in already-complicated pregnancies that are not related to a specific condition, its diagnosis or its therapy.
Department of Perinatology, Sophia Hospital, Zwolle, The Netherlands.
H
H
Arts
J
J
van Eyck
B
B
Arabin
D000328:Adult; D005260:Female; D005313:Fetal Death / Q000453:epidemiology* / Q000209:etiology; D005330:Fetofetal Transfusion / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000503:physiopathology; D011272:Pregnancy, Multiple / Q000502:physiology*; D014102:Torsion Abnormality / Q000150:complications; D014430:Twins, Monozygotic; D014470:Umbilical Cord / Q000002:abnormalities