Placental findings in specific newborn / fetal or maternal conditions
Twin - twin transfusion

Author: Mandolin Ziadie, M.D. (see Authors page)

Revised: 16 October 2017, last major update November 2011

Copyright: (c) 2002-2017,, Inc.

PubMed Search: Twin twin transfusion placenta [title]

Cite this page: Ziadie, M. Twin - twin transfusion. website. Accessed October 22nd, 2018.
Definition / general
  • Unbalanced flow of blood through arteriovenous anastomoses with worse clinical outcome if AV anastomoses without arterioarterial or venovenous anastomoses
  • Results in growth discrepancy and mortality, which is usually marked in second trimester
  • Both twins are at risk (70% mortality)
  • After death of donor twin, may get an acute reverse transfusion
Case reports
  • 22 year old pregnant woman with twins, one with oligohydramnios, one with polyhydramnios (Case of the Week #264)
  • Serial amniocentesis; removal of a fetus
  • Surgical interruption of common vasculature
Gross description
  • Donor twin is anemic, small and pale with small organs
  • Recipient twin is large and plethoric with large organs; at risk for high output cardiac failure
Gross images

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Twin - twin transfusion


Microscopic (histologic) description
  • Donor placentas have large edematous villi, small capillaries and numerous nucleated red blood cells
  • Recipient placenta has small, firm and mature villi with congested vessels