{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:49:42Z","timestamp":1791532182116,"version":"4.3.4"},"reference-count":8,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Parvovirus B19 infection can cause severe fetal anemia. Management in monochorionic twin pregnancies is challenging due to placental vascular connections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case<\/jats:title>\n                    <jats:p>We report a case of severe fetal anemia in both fetuses of a monochorionic diamniotic twin pregnancy following maternal parvovirus B19 infection. Elevated middle cerebral artery peak systolic velocity (MCA\u2010PSV) was first detected at 16\u00a0weeks in twin A and reached 2.32 multiples of the median (MoM) in twin A and 2.30 MoM in twin B at 21+6\u00a0weeks. These findings were associated with polyhydramnios in both fetuses and ascites in twin B. Intrauterine transfusion was performed at 22+1\u00a0weeks, revealing hemoglobin levels of 3\u00a0g\/dL in both fetuses. Transfusion of twin B resulted in an unexpected spontaneous increase in hemoglobin in twin A, suggesting intertwin blood transfer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Following minimal additional transfusion in twin A, MCA\u2010PSV normalized in both fetuses. The pregnancy was subsequently complicated by preeclampsia without severe features, and vaginal delivery occurred at 36+3\u00a0weeks. Both neonates had normal and identical hemoglobin levels at birth. Placental examination after delivery, with dye injection, demonstrated a single large arterio\u2010arterial anastomosis that had not been visualized prenatally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Transfusion of one twin was followed by an immediate rise in hemoglobin in the co\u2010twin, indicating major intertwin blood exchange through a large arterio\u2010arterial anastomosis. Because such exchange cannot be predicted prenatally, both fetuses require individual assessment before and after transfusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70460","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:41:11Z","timestamp":1789141271000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intrauterine transfusion in monochorionic twins with parvovirus B19 infection: Evidence of intertwin blood exchange"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2438-9412","authenticated-orcid":false,"given":"Ninon","family":"Dupuis","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Paule de Viguier Hospital, CHU Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blandine","family":"Hervy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Paule de Viguier Hospital, CHU Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5724-9729","authenticated-orcid":false,"given":"Marl\u00e8ne","family":"Sohier\u2010L\u00e9pine","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Paule de Viguier Hospital, CHU Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4059-8671","authenticated-orcid":false,"given":"Louise","family":"Paret","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Paule de Viguier Hospital, CHU Toulouse  Toulouse France"},{"name":"Inserm UMR1295 CERPOP (Center for Research in Epidemiology and Population Health) Team SPHERE, University Toulouse III  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Vayssi\u00e8re","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Paule de Viguier Hospital, CHU Toulouse  Toulouse France"},{"name":"Inserm UMR1295 CERPOP (Center for Research in Epidemiology and Population Health) Team SPHERE, University Toulouse III  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003891"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1375\/twin.9.3.456"},{"issue":"5","key":"e_1_2_10_4_1","first-page":"419","article-title":"Fetal Parvovirus B19 Infection in a Twin Pregnancy With 1 Twin Presenting With Hydrops Fetalis and the Other Asymptomatic: A Case Report","volume":"52","author":"Leung T. N.","year":"2007","journal-title":"Journal of Reproductive Medicine"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1375\/twin.12.2.175"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102007\u2010994673"},{"issue":"5","key":"e_1_2_10_7_1","first-page":"834","article-title":"Parvovirus B19 Infection in a Twin Pregnancy","volume":"83","author":"Pustilnik T. 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