The Intra-Uterine Feto-Fetal Transfusion

Abstract

THE INTRA-UTERINE feto-fetal transfusion, sometimes called the "human intra-uterine parabiotic syndrome" because of its similarity to the experimental vascular connection in animals, is a rarely recognized phenomenon. The diagnosis is made at the birth of monozygotic twins by observing unequal blood distribution; one twin is anemic, the other plethoric. To date, 35 cases have been reported.^1-9 This report describes a case with unusual findings and presents a pathophysiology of this syndrome. Report of a Case A 17-year-old white mother, after 24 weeks' gestation, delivered male twins precipitously. At birth one twin was cyanotic, the other pale in comparison. The hemoglobin values at birth were 20.6 gm/100 cc and 13.3 gm/100 cc, respectively. The first twin died after 4 hours, the second after 28 hours of life, showing symptoms of a respiratory distress syndrome. An autopsy was refused. The placenta was complete and of the monochorionic-diamnionic type. One umbilical cord