DEATH OF ONE TWIN FOLLOWED BY EXTREMELY VARIABLE FLOW VELOCITY WAVE-FORMS IN THE SURVIVING FETUS

Intrauterine death of one fetus after the second trimester in a twin p regnancy, with continuation of the pregnancy is a rare complication. T he risks of morbidity and mortality for the surviving fetus are high. A 32-year-old woman was admitted to the antenatal ward at 27 weeks ges tation because of intrauterine death of one twin. During the first 24 h after the death of one twin, Doppler ultrasound assessment showed a remarkable variability in flow velocity waveforms in the umbilical art ery of the surviving fetus. Changes from reversed to normal end-diasto lic flow velocities were recorded within 6 min. These findings are exp lained by twin-to-twin transfusion due to intravascular blood pressure changes, or by release of vasoactive substances by the dead fetus.