A monochorionic diamniotic twin pregnancy at 21 weeks has polyhydramnios in the recipient sac, oligohydramnios in the donor sac, and a nonvisualized

Question

A monochorionic diamniotic twin pregnancy at 21 weeks has polyhydramnios in the recipient sac, oligohydramnios in the donor sac, and a nonvisualized donor bladder. Dopplers are otherwise normal. What is the preferred treatment?

Accepted Answer

Refer urgently for fetoscopic laser photocoagulation of placental anastomoses

Answer

Perform selective reduction of the recipient twin as routine treatment

Answer

Deliver both fetuses immediately by cesarean at 21 weeks

Answer

Perform serial amnioreduction alone as definitive first-line therapy

Answer

Observe weekly because normal Dopplers exclude severe disease

Ovarian torsion — USMLE Step 3 MCQ

A monochorionic diamniotic twin pregnancy at 21 weeks has polyhydramnios in the recipient sac, oligohydramnios in the donor sac, and a nonvisualized donor bladder. Dopplers are otherwise normal. What is the preferred treatment?