Maternal coagulopathy after umbilical cord occlusion for twin reversed arterial perfusion sequence

Background: Twin reversed arterial perfusion sequence is a rare complication of monochorionic twin gestations for which therapy involves the disruption of vascular anastomoses between the pump twin and acardiac twin and death of the acardius. Case: A 37-year-old woman, gravida 11 para 2, with a monochorionic twin pregnancy complicated by twin reversed arterial perfusion sequence who underwent umbilical cord occlusion at 24 weeks of gestation was admitted in preterm labor at 33 weeks of gestation. Maternal disseminated intravascular coagulation (DIC) was diagnosed and her labor was induced. She received multiple blood products to correct her coagulopathy and had an uncomplicated vaginal delivery of the viable pump twin. Conclusion: Maternal DIC may complicate fetal death after umbilical cord occlusion.