Acute intrapartum fetoplacental transfusion in monochorionic twin pregnancy

Background: The risk of antenatal fetofetal transfusion in monochorionic twin pregnancies has been noted, but possible acute intrapartum transfusion has not been studied extensively. Acute fetoplacental transfusion after the birth of the first twin can be disastrous to the second twin, so it deserves description. Cases: We present three cases of acute intrapartum fetoplacental transfusion after successful deliveries of first twins. After the births of their cotwins, the second twins rapidly deteriorated and were born severely hypovolemic and anemic. Conclusion: The risk of acute intrapartum tt transfusion should be kept in mind when planning delivery of monochorionic twins. (Obstet Gynecol 1999;94:819-21. (C) 1999 by The American College of Obstetricians and Gynecologists.).