Abstract
Twin–twin transfusion is the major cause of mortality and morbidity in monochorionic twins. Its pathogenesis has been gradually elucidated over the last three centuries. There was a long-lasting controversy among obstetricians regarding the existence of placental anastomoses and whether or not to tie the placental end of the firstborn infant’s cord. However, a twin pregnancy practically never could be ruled out. Stalpart van der Wiel described a twin–twin vessel connection in 1687. Studies on interfetal anastomoses by injecting dyes into placental vessels were published by Smellie in 1752, Osiander in 1781, and Brachet in 1821. Different types of anastomoses, and their associated fetal disorders were classified by Schatz in a series of papers in the late 19th century. With the advent of ultrasound and laser techniques, prenatal diagnosis and treatment became available in the last decade of the 20th century.
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