Single-Twin Demise in Monochorionic Pregnancy: Looking Beyond the Placental Inter-Twin Anastomoses

De Carolis MP, Salvi S, Bersani I, Corsello M and De Carolis S

Department of Paediatrics, Catholic University of Sacred Heart, Rome, Italy
Department of High Risk Pregnancies, Catholic University of Sacred Heart, Rome, Italy

^*Correspondance to: Salvi S 

 PDF  Full Text Case Report | Open Access

Abstract:

The single intrauterine fetal demise is a devastating complication in twin pregnancies. Monochorionic twin pregnancies are at highest risk of co-twin fetal demise for specific complications due to the unique placental architecture with intertwin anastomoses such as twin–twin transfusion syndrome, twin anaemia-polycythaemia sequence and selective intrauterine growth retardation. Other possible causes include fetal infections, chromosome and structural abnormalities and cord anomalies. Ruling out all the differential diagnosis behind a single intrauterine fetal demise is of extreme importance. A case of fetal death in a monochorionic-diamniotic twin pregnancy, initially attributed to an acute twin–twin transfusion syndrome but more probably due to unrecognized prenatal acute cord torsion, is here described. This case emphasizes the importance of always investigate thoroughly all causes associated to an intrauterine fetal demise and of always perform a careful examination of the placenta and cords.

Keywords:

Twin pregnancy; Fetal death; Chorionicity; Twin-twin transfusion syndrome; Cord
torsion

Cite the Article:

De Carolis MP, Salvi S, Bersani I, Corsello M, De Carolis S. Single-Twin Demise in Monochorionic Pregnancy: Looking Beyond the Placental Inter- Twin Anastomoses. Ann Clin Case Rep. 2017; 2: 1312.