The twin-to-twin transfusion syndrome is a serious anomaly occurring from vessels anastomosis between the fetal-planetary circulations of monochorionic twin pregnancies with a high perinatal morbidity and mortality. In the first trimester, the presence of discordant increase of the nuchal translucency associated a reverse blood flow in the ductus venosus are marks of twin-to-twin transfusion syndrome. In this report, we related a case of monochorionic twin pregnancy in the first trimester in that the first diagnostic signal this syndrome was an increase of the measurement of nuchal translucency, associated the reverse blood flow in the ductus venosus of receiving fetus.
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