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A case of monochorionic twin pregnancy complicated with intrauterine single fetal death with successful treatment of intrauterine blood transfusion in the surviving fetus.

Nakata M, Sumie M, Murata S, Miwa I, Kusaka E, Sugino N

Perinatal Care Center, Yamaguchi University Hospital, Ube, Japan. miyabi@yamaguchi-u.ac.jp

We report a case of monochorionic twin pregnancy complicated with single fetal demise that received successful treatment of intrauterine transfusion for severe anemia of the surviving fetus. A single fetal demise occurred at 20 weeks of gestation and middle cerebral artery peak systolic velocity (MCA-PSV), a marker for fetal anemia, showed marked elevation in the surviving fetus. Fetal blood sampling was immediately done and severe fetal anemia (hemoglobin = 5.5 g/dl, hematocrit = 16.8%) was confirmed, and then intrauterine transfusion was performed. After transfusion, MCA-PSV rapidly decreased to the normal value and remained within normal range until delivery. A healthy 2,640 g male infant was delivered at 35 weeks of gestation without anemic status and no neurological problem was found at 1-year old. The present report supports that intrauterine rescue transfusion is a useful treatment to prevent the adverse outcome of surviving fetus in monochorionic twin pregnancy complicated with single fetal demise, and monitoring of MCA-PSV is also useful to assess anemic status of the surviving fetus.

Published 28 December 2006 in Fetal Diagn Ther, 22(1): 7-9.
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