Nonneoplastic placental conditions and abnormalities

Placental findings in specific conditions

Twin - twin transfusion

Last author update: 1 November 2011
Last staff update: 23 February 2021

Copyright: 2002-2024,, Inc.

PubMed Search: Twin twin transfusion placenta [title]

Mandolin S. Ziadie, M.D.
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Cite this page: Ziadie MS. Twin - twin transfusion. website. Accessed February 22nd, 2024.
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
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