SPONTANEOUS REMISSION OF DOUBLE PULSATILE UMBILICAL VENOUS FLOW IN TWIN-TWIN TRANSFUSION SYNDROME - A CASE-REPORT

Double umbilical pulsatile venous flow is a rare event generally assoc iated with fetal right heart failure. We observed, at 21 weeks' gestat ion, this venous flow pattern in a case of twin-twin transfusion syndr ome occurring in the recipient twin affected by severe hydrops. In spi te of a spontaneous remission of fetal hydrops at 30 weeks, the fetus died suddenly in utero, 2 weeks later. We hypothesized that this unexp ected event was related to reversed acute twin-twin transfusion, and c oncluded that fetal hydrops remission in twin-twin transfusion syndrom e must not be considered as a reassuring prognostic index but as an in dication of the need for continuing biophysical monitoring.