title: Acute twin-twin transfusion syndrome: a case report.
abstract: BACKGROUND
  Clinically relevant acute twin-twin transfusion syndrome (TTTS) is a rare and poorly defined placental pathology because the definitions of chronic TTTS do not apply. Antepartum cases of acute TTTS are infrequently described in the literature despite the presence of vascular anastomoses in most monochorionic placentas.
  
  
  METHODS
  A case of otherwise-unexplained acute fetal distress in a monochorionic twin gestation led to an emnergeincy cesarean section and was found to be due to acute heiodynamiic inbalance secondary to activation of a large placental venovenous anastomosis.
  
  
  CONCLUSIONS
  Obstetricians should be aware of this potential cause of sudden fetal distress in monochorionic twin gestations.
authors.affiliation: Women's Hospital, Institute of Pathology, Tübingen University, Tübingen, Germany. sven.becker@med.uni-tuebingen.de
authors.forename: Sven
authors.initials: S
authors.lastname: Becker
authors.forename: Erich
authors.initials: E
authors.lastname: Solomayer
authors.forename: Susanne
authors.initials: S
authors.lastname: Mackensen-Haen
authors.forename: Diethelm
authors.initials: D
authors.lastname: Wallwiener
authors.forename: Tanja
authors.initials: T
authors.lastname: Fehm
mesh_terms: D000328:Adult; D001165:Arteriovenous Malformations / Q000150:complications; D002585:Cesarean Section; D002823:Chorion / Q000098:blood supply*; D005260:Female; D005316:Fetal Distress / Q000209:etiology*; D005330:Fetofetal Transfusion / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006801:Humans; D010920:Placenta / Q000098:blood supply*; D010922:Placenta Diseases / Q000209:etiology; D011247:Pregnancy