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Selective Extrauterine Placental Perfusion in Monochorionic Twins Is Feasible-A Case Series.
Children (Basel)
October 2024
Division of Neonatology, Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.
Article Synopsis
- Monochorionic (MC) twins face risks like twin-to-twin transfusion syndrome (TTTS) and anemia, leading to potential complications during preterm delivery.
- A study investigated a new method called selective extrauterine placental perfusion (EPP) with delayed umbilical cord clamping (DCC) for the donor twin, aiming to reduce anemia while still managing the recipient's condition.
- The results showed that using this EPP method in three cases successfully maintained healthy hemoglobin levels in the donor twins without needing blood transfusions, suggesting it could improve outcomes in similar situations.
Maternal Complications After Laser Surgery for Twin-to-Twin Transfusion Syndrome, a Cohort Study.
Prenat Diagn
November 2024
Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
Article Synopsis
- The study aimed to evaluate maternal complications following fetoscopic laser surgery (FLS) for twin-to-twin transfusion syndrome (TTTS) from 2008 to 2021.
- A total of 637 mothers underwent FLS, resulting in 1559 reported maternal complications, with severe complications occurring in 8.0% of cases.
- The findings highlight that while FLS is an effective treatment for TTTS, it poses significant risks for mothers, warranting thorough discussions with patients about these risks when considering treatment options.
Intertwin discordance of aldosterone levels in amniotic fluid with placental anastomoses in monochorionic twins: Insight into the pathophysiology of twin-to-twin transfusion syndrome.
Acta Obstet Gynecol Scand
August 2024
Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Tokyo, Japan.
Introduction: Our objective was to investigate the association between the presence of placental anastomoses and intertwin differences in renin-angiotensin-aldosterone activation in monochorionic twins using amniotic fluid aldosterone (AF-ALD) levels. In addition, this study also examined the association between AF-ALD and the ALD levels in the umbilical cord blood (UCB-ALD) in monochorionic twins.
Material And Methods: This prospective study included monochorionic diamniotic (MD) twin pregnancies that were not complicated by twin-to-twin transfusion syndrome (TTTS) at delivery.
Role of gestational age at time of placental laser surgery in outcome of twin-to-twin transfusion syndrome.
Ultrasound Obstet Gynecol
May 2024
Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.
Objective: There are conflicting data on whether fetoscopic laser photocoagulation (FLP) of placental anastomoses for the treatment of twin-to-twin transfusion syndrome (TTTS) is associated with lower rates of overall survival. The objective of this study was to characterize twin survival and associated morbidity according to the gestational age at which FLP was performed.
Methods: This was a secondary analysis of data collected prospectively on patients with a monochorionic diamniotic (MCDA) twin pregnancy who underwent FLP for TTTS at two centers between January 2011 and December 2022.
Atypical twin-to-twin transfusion syndrome case managed in a single centre in Indonesia with fetoscopic laser photocoagulation and amniopatch: 'Case Report'.
Ann Med Surg (Lond)
May 2024
Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara.
Introduction And Importance: The diagnostic criteria for Quintero staging in twin-to-twin transfusion syndrome (TTTS) are not applicable in all cases of TTTS, such as those in which the symptoms overlap with other monochorionic twin complications such as selective intrauterine growth restriction (sIUGR).
Case Presentation: A 25-year-old woman, G1P0A0, at 22-24 weeks' gestational age was diagnosed with TTTS, with no outstanding history of medication use during pregnancy, and no family history of genetic disorder or twin pregnancy. In the donor twin, persistently absent end-diastolic flow in the umbilical artery was observed using Doppler velocimetry.
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