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

OBJECTIVES: To add to the nascent literature on twin anemia polycythemia sequence by presenting a unique cardiac complication in the recipient twin. CASE PRESENTATION: 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. CONCLUSIONS: This case report introduces a previously undescribed complication of twin anemia polycythemia sequence and adds to the growing literature on this clinical entity.