Intrauterine Growth Restriction in Twin-Twin Transfusion Syndrome Caused by Placental Insufficiency: A Case Report Diagnosed by Histopathology

Objective: to get the correct information concerning the caused of dead of one fetus (intrauterine fetal death/IUFD ) and intrauterine fetal growth restriction (IUGR) of other fetus of twin pregnancy of 34-36 weeks gestation. Materials and methods: the whole placenta together with the amniotic membrane and umbilical cords of twin pregnancy were examination macroscopically and histopathologic analyzed. Pathologic features: monozygotic twins placentation of monochorionic monoamniotic membrane with twin-twin transfusion syndrome were found. There was a large thrombus and larged old infarct formation at intermediate area of the placenta suspected the cause for the IUFD of one fetus. There were also many fibrine, capillaries occlusion and multiple small infarct of villous vessel suspected the cause for IUGR for the second fetus of twin pregnancy. Results: a big thrombus suspected as the caused for IUFD for one fetus and placental insufficiency as the cause for IUGR on the second fetus. Conclusions: a twin pregnancy of 34-36 weeks gestation with twin-twin transfusion syndrome, a big thrombus caused IUFD for one fetus and placental insufficiency caused IUGR on other fetus.