In twin-to-twin transfusion syndrome, the recipient twin may develop which combination of findings?

In twin-to-twin transfusion syndrome, the recipient twin may develop which combination of findings?

• A. Polycythemia, hydramnios, and heart failure
• B. Anemia, oligohydramnios, and pulmonary hypertension
• C. Normal hematocrit with reduced amniotic fluid
• D. Hypotension and reduced cardiac output

Answer: (A)

In twin-to-twin transfusion syndrome, placental connections cause one twin (the recipient) to receive an excess of blood from the other twin. This creates volume overload in the recipient, which drives several characteristic changes. The increased red cell mass in the recipient leads to polycythemia. The extra blood flow to the fetus also increases kidney perfusion and urine production, producing an excess of amniotic fluid, or hydramnios (polyhydramnios). The heart must handle the overloaded circulation, which can lead to heart failure in the recipient. So this combination—polycythemia, hydramnios, and heart failure—is typical of the recipient twin in TTTS. The donor twin, by contrast, tends to be underperfused, with oligohydramnios and often anemia, reflecting a different pattern of blood flow.

In twin-to-twin transfusion syndrome, placental connections cause one twin (the recipient) to receive an excess of blood from the other twin. This creates volume overload in the recipient, which drives several characteristic changes. The increased red cell mass in the recipient leads to polycythemia. The extra blood flow to the fetus also increases kidney perfusion and urine production, producing an excess of amniotic fluid, or hydramnios (polyhydramnios). The heart must handle the overloaded circulation, which can lead to heart failure in the recipient.

So this combination—polycythemia, hydramnios, and heart failure—is typical of the recipient twin in TTTS. The donor twin, by contrast, tends to be underperfused, with oligohydramnios and often anemia, reflecting a different pattern of blood flow.