Obstetric Ultrasound
.
Amniotic Fluid Discrepancy in Twins:
Thick of TTTS / Twin-twin transfusion syndrome (in MCMA twin), if >>> Oli-Poly = Oligohydramnios in one sac & polyhydramnios in other sac.
Think of isolated oligohydramnios or s-FGR / selective Fetal Growth restriction, if >>> Oli-Normal = Oligohydramnios is one sac & Normal amniotic fluid in other sac.
Think of isolated polyhydramnios or PART / Polyhydramnios Affecting Recipient-like Twin, if >>> Poly-Normal = Polyhydramnios in one sac & Normal amniotic fluid in other sac.
.
.
.
Interpretation of our case:
1 - Twins with discrepancy of amniotic fluid volume between the 2 sacs.
2 - Although one fetus looks stuck as in TTTS, BUT >>> Two placentas are seen = Dichorionic Diamniotic Twins, so TTTS is unlikely.
3 - By measuring MVP in both sacs; MVP in sac A = 12 = Poly. MVP in sac B = 5 = NORMAL (not oligo).
4 - Conclusion: Isolated polyhydramnios, look for a cause in this fetus if possible. After search, Placental chorioangioma was found.