Twin-to-twin transfusion syndrome at 11 weeks of gestation

Second-trimester twin-to-twin transfusion is well known, but first-trimester cases rarely have been described. We present the case of a monochorionic twin at 11 + 0 weeks of gestation with single increased nuchal translucency and normal karyotypes. At 12 + 5 weeks of gestation, double intrauterine death was diagnosed, followed by delivery of a strikingly red and white fetus.