The term cotwin with special pulmonary lesions and elevated maternal-neonatal D- dimer levels following single intrauterine fetal death in a monochorionic-monoamniotic twin pregnancy: a case report and literature review

Abstract

Background Complications such as cerebral impairment, preterm delivery, and even intrauterine death can occur in monochorionic twins with singleton fetal death. The coagulation functions of the surviving fetus and mother are controversial. Case presentation We reported a case of spontaneous single intrauterine fetal death at 17 weeks of gestation in a monochorionic monoamniotic twin pregnancy followed by increased maternal-neonatal D-dimer levels and special pulmonary lesions in the surviving term cotwin without cerebral impairment. The mother was complicated with massive pelvic hematomas postpartum and recovered after conservative treatment. Conclusions Maternal-neonatal follow-up of D-dimer and detailed examination of the respiratory system as well as brain impairment of the surviving cotwin and newborn are recommended, especially in monochorionic monoamniotic twin pregnancies with placental arterio-arterial or veno-venous anastomoses and elevated maternal D-dimer.