• Pooja Agrawal, Achala Vaidya, Anshu Vaidya, Subash Phuyal, and Asmita Pandey.
• Department of Radiology, Norvic International Hospital, Thapathali, Kathmandu, Nepal.
• JNMA J Nepal Med Assoc. 2022 Dec 1; 60 (256): 105610581056-1058.

UnlabelledTwin-twin transfusion syndrome occurs in multiple gestations and involves a chronic flow of blood from one twin to another twin and is a rare entity. We present a case of 32-years-old primigravida with a twin pregnancy who presented with increasing abdominal girth inappropriate with her gestational age at 21 weeks of her pregnancy. Ultrasound findings were suggestive of twin-twin transfusion syndrome. The patient was provided with treatment options but due to polyhydramnios and short cervix, the patient went into spontaneous labour the same day with a poor pregnancy outcome. Twin-twin transfusion syndrome leads to a high rate of perinatal morbidity due to its poorly understood aetiology and difficulty in diagnosing and treatment. Early diagnosis during antenatal ultrasound is important in reducing morbidity and mortality rates.Keywordscase reports; fetoscopy; oligohydramnios; polyhydramnios; twins.

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