Abstract
Fetal Doppler assessment is a useful tool in diagnosing and staging mono-chorionic twins complicated by twin-twin transfusion syndrome (TTTS). 1 Umbilical artery absent or reversed end-diastolic velocity (UA-AREDV) is a poor prognostic factor in TTTS 2 , 3 and is associated with increased risk of in utero fetal death of the donor twin. 4 The etiology of donor twin UA-AREDV has primarily been attributed to 2 placental factors: unequal individual placental territories and the presence of arterioarterial anastomoses. 5 However, umbilical artery (UA) hypoplasia, which can result in UA-AREDV, has not to our knowledge been reported in association with TTTS. We present a case with donor twin umbilical artery absent end-diastolic velocity (UA-AEDV) caused by a hypoplastic UA, with emphasis on the diagnostic and management challenges associated with discordant UA Doppler findings in the setting of TTTS.
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