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 a ll monochorionic pregnancies. The mortality and morbidity rates ave hi gh and ther apeutic options limited. CASE: TTTS in a monochorionic twi n pregnancy teas initially diagnosed by differences in amniotic fluid volume at 26 weeks. No signs of atrioventricular valve insufficiency o r nonimmune hydrops fetalis were present in the recipient. Despite thi s, the recipient died in utero, whereupon the condition of the donor i mproved markedly. After spontaneous delivery at 30 weeks' gestation, c oarctation of the umbilical cord at its insertion was observed in the recipient, probably secondary to severe torsion. CONCLUSION: Unexpecte d obstetric events may occur in already-complicated pregnancies that a re not related to a specific condition, its diagnosis or its therapy.