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El síndrome de transfusión feto-fetal se presenta con mayor frecuencia en los embarazos gemelares monocoriales biamnióticos. En etapas avanzadas y sin una intervención prenatal, se asocia a altas tasas de mortalidad perinatal y de secuelas neurológicas en los sobrevivientes. Se presenta el caso de una pareja de gemelares con depresión severa al nacer, en los que se planteó un síndrome de transfusión feto-fetal, confirmado posteriormente con la presencia de anemia en el gemelo donante y policitemia en el gemelo receptor. Ambos gemelos tuvieron una evolución desfavorable hasta llegar a la muerte neonatal precoz. Los hallazgos de la necropsia fueron compatibles con daños secundarios al síndrome, con la particularidad de que en ambos hubo evidencias de infección pulmonar, y de una malformación renal en el gemelo donante, la cual no se recoge entre las malformaciones propias de este síndrome. El objetivo de este trabajo es puntualizar en los elementos esenciales para el diagnóstico y tratamiento antenatal de esta enfermedad, a través de las peculiaridades del caso que se presenta.

Twin-twin Transfusion Syndrome presents more frequently in diamniotic monochromic twins. In advanced stages and without prenatal intervention, is associated to high rates of peri natal mortality and neurological sequel in the survivors. It is presented a case of a pair of twins with severe depression at birth in which it was diagnosed a Twin-twin Transfusion Syndrome, later confirmed with the presence of anemia in the donor twin and polycythemia in the receptor twin. Both twins had an unfavourable evolution with an early neonatal death. Necropsy findings were comparable with secondary damage to the syndrome, with the particularity that both had evidences of pulmonary infection and a renal malformation in the donor twin which is not included in the proper malformations of this syndrome. The objective of this work is to point out the essential elements for the diagnosis and antenatal treatment for this disease through the peculiarities of the presented case.

Twin-twin Transfusion Syndrome presents more frequently in diamniotic monochromic twins. In advanced stages and without prenatal intervention, is associated to high rates of peri natal mortality and neurological sequel in the survivors. It is presented a case of a pair of twins with severe depression at birth in which it was diagnosed a Twin-twin Transfusion Syndrome, later confirmed with the presence of anemia in the donor twin and polycythemia in the receptor twin. Both twins had an unfavourable evolution with an early neonatal death. Necropsy findings were comparable with secondary damage to the syndrome, with the particularity that both had evidences of pulmonary infection and a renal malformation in the donor twin which is not included in the proper malformations of this syndrome. The objective of this work is to point out the essential elements for the diagnosis and antenatal treatment for this disease through the peculiarities of the presented case. [ABSTRACT FROM AUTHOR]