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Case Report
Peer-Review Record

Acute Twin-to-Twin Transfusion Syndrome Resulting in Fetal Bradycardia and Neonatal Death: A Case Report

Medicina 2022, 58(12), 1813; https://doi.org/10.3390/medicina58121813
by Mi Ju Kim 1,2, Hyun Mi Kim 1,2, Hyun-Hwa Cha 1,2, Haemin Kim 2, Hyo-Shin Kim 2 and Won Joon Seong 1,2,*
Reviewer 1:
Reviewer 2: Anonymous
Medicina 2022, 58(12), 1813; https://doi.org/10.3390/medicina58121813
Submission received: 31 October 2022 / Revised: 23 November 2022 / Accepted: 8 December 2022 / Published: 9 December 2022
(This article belongs to the Section Cardiology)

Round 1

Reviewer 1 Report

The author reported a interesting case of TTTS, However, the diagnose of aTTTS is open to discussion. in this case, we can see the polyhydramnios and oligohydramnion,and the last Ultrasound was 6 days ago,so the author should dicuss it in the Discussion part. Whether it is a TTTS or aTTTS, should aTTTS  have the polyhydramnios and oligohydramnion? 

Therefore, it is suggested that the authors add the discussion content of whether aTTTS should show the sequence of polyhydramnios or oligohydramnios in the discussion section, combined with literature review.

Author Response

Thank you for your previous advice. 

In TTTS, oligohydramnios occur in donor twins, and polyhydramnios occur in recipient twins by vascular anastomosis. Six days before the acute TTTS occurred, the AFI of both fetus in the ultrasound was normal and similar, so it is not considered to be a chronic TTTS. During the event, the two fetuses showed a polyhydromnios-anhydromanios sequence, and the Hb difference between the two fetus was confirmed to be 8.3, which can be considered to meet the diagnostic criteria of acute TTTTS. I inserted this content in the paragraph. 

Reviewer 2 Report

Please refer the attached file. 

Comments for author File: Comments.pdf

Author Response

Please see the attatchment  

Author Response File: Author Response.docx

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