Pravastatin and L-Arginine Use in Early-Onset Severely Growth-Restricted Dichorionic Twins: A Case Report

15 November 2025 : Case report USA

Unusual clinical course, Unusual or unexpected effect of treatment, Educational Purpose (only if useful for a systematic review or synthesis)

Christina A. Herrera

^{ABCDEF 1}, Neeraj Desai^{CDE 1}, Jessica P. McAlister^{ABCEF 1}, Angelina Avdella^{DE 1}, Stephen J. Carlan

^{CDE 1,2*}

DOI: 10.12659/AJCR.948773

Am J Case Rep 2025; 26:e948773

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Table 1 Umbilical artery Doppler progression.

Intervention	Gestational age	Twin A	Twin B
	19w3d	Normal	Normal
Pravastatin and L-arginine initiated	21w3d	Normal	Persistently absent EDF
	23w3d	Normal	Intermittently absent EDF
Betamethasone course #1 administered	24w0d
	25w5d	Elevated pulsatility index	Intermittently absent EDF
Betamethasone course #2 administered	26w0d
	28w0d	Normal	Intermittently absent EDF
	30w0d	Elevated pulsatility index	Elevated pulsatility index
	32w0d	Normal	Elevated pulsatility index
EDF – end diastolic flow.

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