# An unusual case of twin anemia polycythemia sequence complicated by premature ductus arteriosus constriction of the recipient twin

## TL;DR

A rare case of twin anemia polycythemia sequence is reported with a unique heart complication in the recipient twin.

## Contribution

This case report introduces a previously undescribed cardiac complication in twin anemia polycythemia sequence.

## Key findings

- Recipient twin developed right heart failure due to premature ductus arteriosus constriction.
- Iatrogenic preterm delivery was required to prevent intrauterine demise.
- Adds a unique complication to the literature on twin anemia polycythemia sequence.

## Abstract

To add to the nascent literature on twin anemia polycythemia sequence by presenting a unique cardiac complication in the recipient twin.

We describe a monochorionic diamniotic pregnancy complicated by twin anemia polycythemia sequence wherein the recipient twin developed signs of right heart failure secondary to premature ductus arteriosus constriction, requiring iatrogenic preterm delivery to avoid intrauterine demise.

This case report introduces a previously undescribed complication of twin anemia polycythemia sequence and adds to the growing literature on this clinical entity.