Obstetric imaging: twin-twin transfusion syndrome: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Obstetric imaging: twin-twin transfusion syndrome

Sample item

In a monochorionic diamniotic twin pregnancy at 20 weeks, one twin has a large bladder and polyhydramnios and the other has a small bladder, oligohydramnios and appears stuck against the uterine wall. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Twin-twin transfusion syndrome

Vascular anastomoses in a shared monochorionic placenta shunt blood from the donor to the recipient, so the donor becomes oliguric with oligohydramnios and the recipient polyuric with polyhydramnios. Fetoscopic laser ablation of the anastomoses is the treatment.

Option by option

  • A. Twin reversed arterial perfusion alone

    TRAP involves an acardiac twin.

  • B. Twin-twin transfusion syndrome (correct)

    Correct. Oligo and polyhydramnios in a monochorionic pair is TTTS.

  • C. Conjoined twins

    Conjoined twins share body parts.

  • D. Dichorionic twin discordance

    Dichorionic twins have separate placentas without this shunt.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Twin-twin transfusion syndrome. Vascular anastomoses in a shared monochorionic placenta shunt blood from the donor to the recipient, so the donor becomes oliguric with oligohydramnios and the recipient polyuric with polyhydramnios.

Why is "Twin reversed arterial perfusion alone" not the answer?

TRAP involves an acardiac twin.

Why is "Conjoined twins" not the answer?

Conjoined twins share body parts.

Why is "Dichorionic twin discordance" not the answer?

Dichorionic twins have separate placentas without this shunt.

What concept does this question test?

It tests Obstetric imaging: twin-twin transfusion syndrome in Radiology. Fetoscopic laser ablation of the anastomoses is the treatment.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Obstetric imaging: twin-twin transfusion syndrome?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.