Twin-to-twin transfusion syndrome

Case contributed by Dr James Harvey


Follow-up obstetric ultrasound in a patient with MCDA twins.

Patient Data

Age: 25 years
Gender: Female

MCDA twins. Posterior placenta.

Twin A (donor):
Cephalic presentation. Oligohydramnios with deepest vertical pocket measuring only 0.7 cm.
Reduced MCA pulsatility index. Intermittent absent end diastolic flow within the umbilical artery. MCA S/D ratio (2.1) less than umbilical artery S/D ratio (4.5).

Twin B (recipient):
Cephalic presentation. Polyhydramnios with deepest vertical pocket measuring 10.6 cm. Large bladder. No hydrops.

Case Discussion

Features of twin-to-twin transfusion syndrome (TTTS) with abnormal Dopplers within the donor twin, reflecting stage III TTTS.

The patient underwent laser photocoagulation that same day.

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