Clinical case of feto-fetal transfusion syndrome development in dichorionic twin pregnancies with fused placentas

Abstract

This article analyzes a clinical case of feto-fetal transfusion syndrome development in dichorionic diamniotic twin pregnancies with fused placentas. Feto-fetal transfusion syndrome is a typical complication of the monochorionic type of placentation, but it is quite rare in the dichorionic type of placentation. In this case, the syndrome development became possible due to the close anatomical location of the placentas, which probably led to their fusion and the development of unbalanced interplacental anastomoses. During the observation of the patient in an antenatal clinic, no ultrasound signs of feto-fetal transfusion syndrome were detected. At a 25+5-week gestation period, the patient complained of cramping pains in the lower abdomen and liquid discharge from the genital tract. The patient was hospitalized at the second stage of labor and gave birth through the natural birth canal. The first fetus had polyhydramnios, the second one having extremely low water. The first was a premature boy in the occiput posterior position weighing 980 g and 32 cm in height in a state of severe asphyxia with an Apgar score of 1, 4 and 6 points. The second was a premature boy in breech position weighing 490 g and 32 cm in height, also in a state of severe asphyxia with an Apgar score of 1, 4 and 6 points. The first child developed severe multiple organ failure, which caused death on the twelfth day. The second newborn developed respiratory distress followed by death on the second day of the neonatal period.