Twin embolisation syndrome

The twin embolisation syndrome (TES) is a rare complication of a monozygotic twin pregnancy following an in utero demise of the co-twin.

It was traditionally thought to result from the passage of thromboplastic material into the circulation of the surviving twin which causes ischemic structural defects in various organs (particularly the highly vascularised organs such as the central nervous system, gastrointestinal tract, and genitourinary system). Acute haemodynamic shift from live to dead fetus resulting in hypoperfusion is more recently thought to play a role 3.

Associations

There is usually an underlying twin-twin transfusion syndrome as a causative association.

Antenatal ultrasound

The presence of a dead twin associated with a surviving twin with various anomalies may suggest the diagnosis. Such anomalies include :

CNS anomalies
Non CNS anomalies

While it carries a poor outcome, prenatal sonographic diagnosis may influence antenatal neonatal management of the surviving monozygous twin 1.

Share article

Article information

rID: 13599
System: Obstetrics
Section: Syndromes
Tag: cases
Synonyms or Alternate Spellings:
  • Twin embolisation syndrome (TES)
  • Twin embolization syndrome

Support Radiopaedia and see fewer ads

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.