Figure 37. Early pregnancy loss with twin transfusion after death of the first sibling. Note that the pale twin is larger than the dark red twin. The chronic recipient commonly will die first, of congestive heart failure due to chronic circulatory overload. If the chronic donor dies, it is generally due to chronic deprivation, or due to cord accident. Cord accident can occur in the donor twin in a diamniotic monochorionic twin pregnancy, when oligohydramnios due to chronic decreased fetal urination can make it harder for the cord to escape compression.