[Pathology of the placenta. XI. Feto-fetal transfusion syndrome]

An account is given in this part of the series of placental alterations in the foeto-foetal transfusion syndrome of monochorial twin pregnancies. Arteriovenous or less often arterio-arterial anastomoses between the two parts of the placenta were found to be conditions for such foeto-foetal transfusion. Blood is discharged on the foetal side from one twin to the other, with one of the twins being adversely affected in growth and general development (donor), which may be as bad as acardia in case of very early onset of transfusion. The other twin (recipient) will undergo better development but will as well be impaired by cardiac hypertrophy and other organic lesions due to excessive inflow of blood. The placenta of the donor--quite often meeting intra-uterine death--usually is smaller than that of the recipient. It is severely anaemic and, additionally, may be of inadequate maturity. The placenta of the recipient may exhibit strongly pronounced hyperaemia, up to A and B angiomatosis. The author describes two of his own cases, with reference being made to morphological findings.