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Twin-twin transfusion syndrome

Case contributed by Maulik S Patel
Diagnosis certain

Presentation

Primigravida for 18 wks scan. No complaints. 12 wks USG - Monochorionic, diamniotic pregnency.

Patient Data

Age: 27 yrs
Gender: Female
ultrasound

Right sided fetus is smaller. It is stuck to right lateral uterine wall. There is restricted fetal movements due to oligo hydramnios. Fetal stomach and bladder are present.  Umbilical artery to right fetus shows presence of diastolic flow with PI of 1.7. 

There is polyhydramnios in left sac. Left fetus shows cardiomegaly. 

Case Discussion

Findings favor twin-twin transfusion syndrome.

Staging ( according to severity ) by Quintero et al :

  • stage I: visible bladder in donor twin with normal Dopplers

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