Survival of twins after acute fetal hemorrhage from ruptured vasa previa.

Vasa previa was suspected when sudden bleeding occurred in a twin pregnancy during an attempt to attach a scalp electrode. Shortly thereafter, we observed sustained fetal bradycardia using a portable ultrasound. Delivery was accomplished immediately with cesarean section, and an exsanguinated twin A and a normal twin B were delivered. After appropriate resuscitation and transfusion, twin A recovered, and both neonates appear normal at the age of 6 months. According to our review of the literature, this is the first reported case in which both twins survived vasa previa complicated by ruptured membranes.