Iatrogenic monoamniotic twin gestation with progressive twin-twin transfusion syndrome

Objective: Intentional puncture of the membrane has been reported to be a p romising new method for the management of twin-twin transfusion syndrome. C ase Report: Treatment of twin-twin transfusion syndrome with serial amnioce nteses resulted in unintentional puncture of the dividing membrane at 24 we eks of gestation. Fetal growth discordance increased, and twin-twin transfu sion did not improve following the puncture. Intrauterine death of both fet uses at 27 weeks of gestation occurred, Conclusion: Amniotic septostomy for the treatment of twin-twin transfusion sydnrome should be performed with s erious consideration.