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Although all monochorionic twins have vascular anastomoses and thus intertwin transfusion, the clinical syndrome develops in only 15 percent. This results in midtrimester discordance in amniotic-fluid levels and growth between the twins, with signs of hypovolemia and uteroplacental insufficiency in the donor and hypervolemia and cardiac dysfunction in the recipient (Figure
Source Information
From the Institute of Reproductive and Developmental Biology, Imperial College London, and the Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Hammersmith Campus both in London.
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