2 Weeks Of Progressive in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#18500

SMLE Question #18500

Obstetrics & Gynecology General Gynecology

Objective: OBJ-OBG-FTS-001

Last updated: February 2026
A 28-year-old G1P0 woman at 24 weeks’ gestation presents with 2 weeks of progressive exertional dyspnea. Ultrasound shows a monochorionic diamniotic twin pregnancy with polyhydramnios in one sac (deepest vertical pocket 9 cm) and oligohydramnios in the other (deepest vertical pocket 1 cm). The donor twin’s urinary bladder is not visualized, and umbilical artery Doppler shows absent end-diastolic flow. There are no contractions or vaginal bleeding. What is the most appropriate next step in management?

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