Fetal Growth Restriction and Anemia in Both Fetuses of Monochorionic Diamniotic Twins with Suspected Chronic Abruption-Oligohydramnios Sequence: A Case Report

Fateme  Gholshahi; Nafise  Saedi; Behrokh  Sahebdel; Shirin Shamel  Jahromi; Roksana  Moeini; Sima  Amini

doi:10.18502/crcp.v10i4.21105

Fateme Gholshahi Department of Obstetrics and Gynecology, Maternal Fetal and Neonatal Research Center, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Nafise Saedi Department of Obstetrics and Gynecology, Maternal Fetal and Neonatal Research Center, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Behrokh Sahebdel Department of Obstetrics and Gynecology, Maternal Fetal and Neonatal Research Center, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Shirin Shamel Jahromi Department of Pediatrics, School of Medicine, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Roksana Moeini Department of Pediatrics, School of Medicine, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Sima Amini Department of Obstetrics and Gynecology, Yas Hospital complex, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/crcp.v10i4.21105

Keywords: Chronic abruption- oligohydramnios sequence, Monochorionic diamniotic twins, Fetal growth restriction (FGR), Fetal anemia

Abstract

We present a case of a primigravida woman at 30 weeks of gestation with monochorionic diamniotic (MCDA) twins, both affected by fetal growth restriction (FGR) and fetal anemia. One twin demonstrated absent end-diastolic flow on umbilical artery Doppler. Both twins had oligohydramnios. The placenta was enlarged (~110 mm in thickness) and showed gross clots at delivery, consistent with chronic placental abruption. Amniotic fluid was blood-stained during the cesarean section performed due to recurrent late decelerations. Placental pathology was normal except for mild vascular abnormalities. TORCH and antiphospholipid syndrome (APS) screenings were negative. This case highlights the diagnostic complexity of FGR and fetal anemia in both fetuses of MCDA twins and supports the chronic abruption-oligohydramnios sequence as the underlying cause.