Abstract
A 33-year-old monochorionic twin gravida was subjected to a cesarean section at 31 weeks’ gestation due to preeclampsia. The pregnancy was otherwise uneventful. The first-born infant (Figure 1) was pale, weighed 1095 g and had an AS of 8/9/9; the second-born twin (Figure 2) was plethoric, weighed 1465 g and had an AS of 9/10. Hb values for twin 1 and twin 2 were 5.8 g/dL and 24.9 g/dL and a reticulocyte count of 11.25% and 6.09%, respectively. The anemic infant was hypovolemic requiring two blood transfusions on day 1. A partial volume exchange transfusion was required for the polycythemic twin, since hematocrit increased to 73.7% on day 1 despite IV hydration.
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