Summary

We report a case of reversal of twin-to-twin transfusion syndrome (Stage IV TTTS) at 24  weeks of gestation after fetoscopic laser photocoagulation (FLP) for communicating vessels. The pathology of reversal of TTTS found that the ‘initial’ donor developed polyhydramnios whereas the ‘initial’ recipient developed oligohydramnios. With careful follow-up, the hydrops fetalis of the ‘initial’ recipient improved at 31 weeks of gestation. Because of the onset of labour pain at 34  weeks of gestation, two live and healthy babies were delivered by emergency caesarean section.