title: A case of monochorionic twin pregnancy complicated with intrauterine single fetal death with successful treatment of intrauterine blood transfusion in the surviving fetus.
abstract: We report a case of monochorionic twin pregnancy complicated with single fetal demise that received successful treatment of intrauterine transfusion for severe anemia of the surviving fetus. A single fetal demise occurred at 20 weeks of gestation and middle cerebral artery peak systolic velocity (MCA-PSV), a marker for fetal anemia, showed marked elevation in the surviving fetus. Fetal blood sampling was immediately done and severe fetal anemia (hemoglobin = 5.5 g/dl, hematocrit = 16.8%) was confirmed, and then intrauterine transfusion was performed. After transfusion, MCA-PSV rapidly decreased to the normal value and remained within normal range until delivery. A healthy 2,640 g male infant was delivered at 35 weeks of gestation without anemic status and no neurological problem was found at 1-year old. The present report supports that intrauterine rescue transfusion is a useful treatment to prevent the adverse outcome of surviving fetus in monochorionic twin pregnancy complicated with single fetal demise, and monitoring of MCA-PSV is also useful to assess anemic status of the surviving fetus.
authors.affiliation: Perinatal Care Center, Yamaguchi University Hospital, Ube, Japan. miyabi@yamaguchi-u.ac.jp
authors.forename: Masahiko
authors.initials: M
authors.lastname: Nakata
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sumie
authors.forename: Susumu
authors.initials: S
authors.lastname: Murata
authors.forename: Ichiro
authors.initials: I
authors.lastname: Miwa
authors.forename: Emiko
authors.initials: E
authors.lastname: Kusaka
authors.forename: Norihiro
authors.initials: N
authors.lastname: Sugino
mesh_terms: D000328:Adult; D000740:Anemia / Q000209:etiology / Q000628:therapy*; D001805:Blood Transfusion, Intrauterine; D005260:Female; D005313:Fetal Death / Q000503:physiopathology*; D005315:Fetal Diseases / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010929:Placentation / Q000502:physiology; D011247:Pregnancy; D014430:Twins, Monozygotic / Q000502:physiology*