Acute twin-twin transfusion syndrome - A case report

BACKGROUND: Clinically relevant acute twin-twin transfusion syndrome (TTTS) is a rare and poorly defined placental pathology because the definitions of chronic TTTS do not apply. Antepartum cases of acute TTTS are infrequently described in the literature despite the presence of vascular anastomoses in most monochorionic placentas. CASE: A case of otherwise unexplained acutefetal distress in a monochorionic twin gestation led to an emergency cesarean section and was found to be due to acute hemodynamic imbalance secondary to activation of a large placental venovenous anastomosis. CONCLUSION: Obstetricians should be aware of this potential cause of sudden fetal distress in monochorionic twin gestations.