3,084 results match your criteria: "Twin-to-Twin Transfusion Syndrome"
Learning curve for the perinatal outcomes of radiofrequency ablation for selective fetal reduction: a single-center, 10-year experience from 2013 to 2023.
J Perinat Med
December 2024
Department of Obstetrics and Gynecology, 26447 Peking University First Hospital, Beijing, China.
Objectives: To investigate the perinatal outcomes of SR using radiofrequency ablation (RFA) in MC pregnancies, identified factors affecting these outcomes, and assessed the associated learning curve.
Methods: This retrospective cohort study included all consecutive MC pregnancies that required RFA from September 2013 to April 2023 at our institution. The perinatal outcomes were compared on the basis of various indications, and binary logistic regression analysis was performed to identify the risk factors for cotwin loss.
Counselling in Fetal Medicine: Complications of Monochorionic Diamniotic Twin Pregnancies.
J Clin Med
November 2024
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, 00185 Roma, Italy.
Twin pregnancies are at increased risk of morbidity and mortality compared to singletons. Among all twins, monochorionic pregnancies are at higher risk of specific and non-specific complications compared to dichorionic pregnancies. Therefore, it is of great importance to properly counsel future parents with monochorionic pregnancies regarding the risks of adverse outcomes and the modalities of monitoring and intervention of the potential complications.
View Article and Find Full Text PDFAmplitude-integrated electroencephalography showed alterations in cerebral activity in monochorionic twins with twin-to-twin transfusion syndrome.
Acta Paediatr
December 2024
Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria.
Aim: Monochorionic twins are at higher risk of perinatal mortality and morbidity, primarily due to pregnancy-related complications, such as twin-to-twin transfusion syndrome (TTTS). We aimed to investigate whether amplitude-integrated electroencephalography (aEEG) signals are different between monochorionic twins with and without TTTS.
Methods: This was a retrospective single-centre study conducted at Innsbruck Medical University Hospital, Austria.
The Process of Developing a Comprehensive Maternal-Fetal Surgery Center.
Am J Obstet Gynecol MFM
November 2024
Division of Pediatric Surgery, Department of Surgery, Oregon Health & Science University, Portland, Oregon, USA.
Article Synopsis
- Fetal therapy has evolved to include treatments for complex fetal disorders, leading to the establishment of specialized maternal-fetal surgery centers across the country.
- These centers adopt a multidisciplinary approach to prioritize both the safety of pregnant patients and the health of the fetus.
- While existing literature outlines what makes an effective center, there’s a lack of guidance on how to actually create one, highlighting the complex and resource-intensive journey involved in building these facilities.
Speckle Tracking Echocardiography in Twin Pregnancies and the Role of Global Longitudinal Strain and Peak Systolic Strain: A Systematic Review and Meta-Analysis.
Fetal Diagn Ther
November 2024
Department of Obstetrics and Gynecology, Ghent University Hospital, Ghent, Belgium.
Article Synopsis
- - Twin pregnancies have a higher risk of complications like fetal growth restriction and twin-to-twin transfusion syndrome (TTTS), which can affect the fetal heart's hemodynamics.
- - This paper reviews existing literature on fetal cardiac function in twin pregnancies using two-dimensional speckle tracking echocardiography (2D STE), finding significant differences in heart strain between donor and recipient twins.
- - Although 2D STE proved feasible for studying monochorionic diamniotic (MCDA) twins, inconsistent results due to varying methodologies indicate a need for further research on its use in uncomplicated twin pregnancies.
Cord Occlusion in Twin Reversed Arterial Perfusion Sequence: A Retrospective Study of Laser Photocoagulation versus Radiofrequency Ablation.
Fetal Diagn Ther
November 2024
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA.
Article Synopsis
- Twin reversed arterial perfusion (TRAP) sequence affects identical twins and can be managed with umbilical cord occlusion (UCO) to improve the survival of the healthier twin, known as the "pump twin."
- A study compared the effectiveness of two techniques used in UCO—laser photocoagulation and radiofrequency ablation (RFA)—on the outcomes of high-risk TRAP sequence cases.
- Results showed no significant difference in 30-day neonatal survival rates between the two treatment methods, with survival rates of approximately 91.9% for laser and 89.2% for RFA.
Placental Vascular Anastamoses and Associated Pathologies in Dichorionic Twin Gestations.
Twin Res Hum Genet
August 2024
Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA.
Article Synopsis
- Traditional beliefs held that placental vascular anastomoses only occur in monochorionic pregnancies, but recent reports show they can also be present in dichorionic twins.
- Conditions like twin to twin transfusion syndrome (TTTS) and twin anemia polycythemia sequence (TAPS) can affect these dichorionic pregnancies.
- The authors discuss a specific case and existing literature to highlight the need for more research on these conditions in dichorionic gestations to improve prenatal care and reduce risks.
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.
Differential postnatal cardiovascular course of donor-recipient twins and associated pathophysiology-a cohort study.
Am J Physiol Heart Circ Physiol
December 2024
Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.
Article Synopsis
- Fetal echocardiography studies show that twins affected by twin-to-twin transfusion syndrome (TTTS) exhibit impaired cardiac function, highlighting a need for further investigation post-birth.
- In a study comparing donor-recipient twin pairs to singleton infants, significant differences in cardiac structure and function were observed, particularly between the recipient twins and singletons.
- The findings indicate that both cardiac function and arterial properties are compromised in TTTS twins, suggesting a necessity for ongoing monitoring after birth to address potential cardiovascular issues.
Predictive Indicators and Outcomes of Pregnancies Affected by Stage I Twin-Twin Transfusion Syndrome Treated With Fetoscopic Laser Photocoagulation.
Prenat Diagn
November 2024
Maternal Fetal Medicine, Osaka Women's and Children's Hospital, Izumi, Japan.
Article Synopsis
- * Out of 272 twin pairs, the survival rates were very high, with 98% of at least one twin surviving and 85% for both, while 93% of recipient twins and 90% of donor twins survived.
- * The research identifies preoperative anemia-polycythemia sequence and arterio-arterial vascular anastomosis (AAA) as significant risk factors for mortality in donor twins after FLP, although the exact mechanisms of AAA need further investigation.
A rare cause of respiratory distress in preterm infants: a case report of acquired subglottic cysts.
Ital J Pediatr
October 2024
Departement of Mother and Child, Neonatal Intensive Care Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy.
Article Synopsis
- Subglottic cysts (SGCs) are rare but serious causes of breathing problems in premature infants, often linked to factors like male gender and invasive ventilation.
- A case study details a premature male infant born at 25 weeks who developed SGCs after extended intubation, leading to severe airway obstruction treated by tracheotomy and cyst removal.
- The findings highlight the importance of considering SGCs in similarly affected preterm infants, emphasizing the need for early diagnosis and intervention to improve outcomes.
Survival rates in pregnancies complicated by twin-to-twin transfusion syndrome undergoing laser therapy: a systematic review and meta-analysis: Survival rates in twin-to-twin transfusion syndrome.
Am J Obstet Gynecol MFM
October 2024
Fetal Medicine Unit, Saint George's Hospital, London, UK; Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK; Twins and Multiples Centre for Research and Clinical Excellence; Fetal Medicine Unit, Liverpool Women's Hospital, University of Liverpool, Liverpool, UK. Electronic address:
Article Synopsis
- Twin-to-twin transfusion syndrome (TTTS) can cause problems for both babies, and doctors want to understand how severe it is to help with survival rates after treatment.
- They reviewed a lot of studies to see how well both twins survive depending on the severity of TTTS, which is measured in stages.
- The results showed that around 73% of twins survive when TTTS is stage I, but the survival drops to about 48% and 53% for stages III and IV, which are more severe.
Fetal MRI findings, etiology, and outcome in prenatally diagnosed schizencephaly.
AJNR Am J Neuroradiol
October 2024
From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (EG, OAG), Department of Neurology, University of California, San Francisco, CA (RV, DG), Albert Einstein College of Medicine, Bronx, NY (YY), Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA (MET), Department of Pediatrics, University of California San Francisco (DG).
Article Synopsis
Use of Web-Based Surveys to Collect Long-Term Pediatric Outcomes in Patients With Twin-Twin Transfusion Syndrome Treated With Fetoscopic Laser Photocoagulation: Observational Study.
JMIR Pediatr Parent
September 2024
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston, 6410 Fannin Street, Suite 201, Houston, TX, 77030, United States, 1 (832) 325 7288, 1 713 383 1464.
Article Synopsis
- The study focused on assessing long-term pediatric outcomes for children with monochorionic diamniotic twins who underwent fetoscopic laser photocoagulation (FLP) for twin-twin transfusion syndrome (TTTS).
- Researchers utilized a web-based survey through REDCap to collect parent-reported outcomes from families across the U.S. and beyond, targeting patients treated from 2011 to 2019.
- The study achieved a survey response rate of 37.3% in 2019 and 57.8% in 2020, with high completion rates across various questionnaires designed to evaluate the children's developmental status.
Real-time placental vessel segmentation in fetoscopic laser surgery for Twin-to-Twin Transfusion Syndrome.
Med Image Anal
January 2025
Harvard Medical School, Boston, MA, United States of America; Center for Advanced Medical Computing and Simulation, Massachusetts General Hospital, Boston, MA, United States of America. Electronic address:
Article Synopsis
- Twin-to-Twin Transfusion Syndrome (TTTS) affects 15% of identical twins sharing a placenta, and the standard treatment is fetoscopic laser photocoagulation (FLP), which improves fetal survival by correcting abnormal blood vessel connections.
- The proposed solution, TTTSNet, is a network architecture that enhances visualization of placental vessels during FLP surgery, utilizing advanced techniques for accurate vessel segmentation and addressing specific challenges encountered during the procedure.
- Trained on a dataset of video frames from fetoscopic procedures, TTTSNet showed significant performance growth over existing methods, achieving high accuracy and speed, which could enable real-time surgical applications.
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.
Dichorionic triamniotic triplets after two blastocysts transfer underwent multifetal pregnancy reduction: two case reports and literature review.
BMC Womens Health
September 2024
Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, China.
Article Synopsis
- The rise in multiple pregnancies is linked to assisted reproductive technology, with a focus on minimizing risks associated with dichorionic triamniotic (DCTA) triplet pregnancies.
- The article presents two cases where multifetal pregnancy reduction (MFPR) was performed to convert high-risk DCTA triplets to safer dichorionic diamniotic (DCDA) twins, allowing for a healthier pregnancy outcome.
- The study suggests that for couples facing multiple pregnancies, reducing DCTA triplets to DCDA twins could be a feasible option, contingent on the clinical assessment of the situation.
IFMSS at Forty: You Heard It Here First.
Fetal Diagn Ther
August 2024
Division of Pediatric Surgery, Fetal Treatment Program of New England, Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Article Synopsis
- The International Fetal Medicine and Surgery Society (IFMSS) was established over 40 years ago to create a collaborative environment for fetal medicine specialists worldwide, promoting open discussion on innovations and challenges in the field.
- A review of their annual conference presentations revealed a shift in focus from observational studies to more invasive procedures over time, with important topics evolving along with technological advances.
- Throughout its history, IFMSS has maintained its role as a leader in fetal medicine, often publishing findings ahead of broader scientific literature, highlighting its significance in advancing fetal diagnostics and therapies.
Fetal Intraparenchymal Hemorrhage Imaging Patterns, Etiology, and Outcomes: A Single Center Cohort Study.
Ann Neurol
December 2024
Department of Neurology, University of California San Francisco, San Francisco, CA.
Article Synopsis
- - This study looked into how different MRI injury patterns in fetuses with intraparenchymal hemorrhage (IPH) relate to their causes and outcomes, using data from cases diagnosed between 1996 and 2022.
- - Researchers analyzed 44 fetuses, noting that most IPH cases were supratentorial and often linked with conditions like twin-twin transfusion syndrome and certain genetic variants (COL4A1/2).
- - The findings showed a high prevalence of neurological issues in surviving infants, with many developing cerebral palsy, developmental delays, and epilepsy, emphasizing the need for genetic evaluations in unexplained cases of fetal IPH.
Twin reversed arterial perfusion (TRAP) sequence and placenta accreta.
Eur J Obstet Gynecol Reprod Biol
November 2024
Department of Gynecology and Obstetrics, Hôpital Couple Enfant, Université Grenoble Alpes, La Tronche, France.
Article Synopsis
- TRAP sequence is a serious complication that occurs in monozygotic (identical) twin pregnancies.
- A case study describes a 35-year-old woman who experienced TRAP in her second pregnancy, leading to a complex delivery with severe hemorrhage and the need for a hysterectomy due to unknown placenta accreta.
- The text suggests that while abnormal placentation is more common in multiple pregnancies, the physiological processes behind TRAP may increase the risk of related placental issues like accreta.
Evaluation of the efficacy of intrauterine treatments of twin-to-twin transfusion syndrome using myocardial performance index.
Quant Imaging Med Surg
August 2024
Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, China.
Article Synopsis
- The study focused on evaluating fetal cardiac function in cases of twin-to-twin transfusion syndrome (TTTS) using the myocardial performance index (MPI) and considered the impact of different intrauterine treatments.
- Data from 68 TTTS cases were compared to 68 healthy monochorionic diamniotic (MCDA) twins, examining MPI before and after treatments like amnioreduction, fetoscopic laser photocoagulation, and selective reduction.
- Results showed that while recipients had higher MPI values compared to control twins, only fetoscopic laser photocoagulation and selective reduction led to a significant decrease in MPI values post-treatment, suggesting improvements in cardiac function following these interventions.
Sensitive detection of hemodynamic changes after fetoscopic laser photocoagulation by assessing intraventricular pressure difference in fetuses with twin-to-twin transfusion syndrome.
J Perinat Med
October 2024
Department of Obstetrics and Gynecology, Faculty of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Article Synopsis
- The study aimed to evaluate the hemodynamics of twin-to-twin transfusion syndrome (TTTS) by measuring intraventricular pressure difference (IVPD) using fetal echocardiography in monochorionic diamniotic twins.
- Twenty-eight twins diagnosed with TTTS underwent fetoscopic laser photocoagulation (FLP), and their cardiac IVPD was assessed before and after the procedure, revealing significant increases in IVPD in both the recipient and donor twins' left ventricles.
- The findings suggest that IVPD is a sensitive indicator of changes in myocardial function and could be valuable for monitoring heart issues in TTTS cases.
Pre- and Periviable PPROM after Fetoscopic Laser Surgery: Are Survival Outcomes Better than We Think?
Fetal Diagn Ther
December 2024
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA.
Article Synopsis
- The study focuses on the outcomes of patients who experience pre- and periviable preterm premature rupture of membranes (pPPROM) after fetoscopic laser surgery (FLS) for twin-twin transfusion syndrome (TTTS).
- It analyzed data from 171 FLS cases, finding that 18.8% of 96 included subjects experienced pPPROM, with significant differences in dual survivorship and perinatal outcomes compared to those without pPPROM.
- Despite lower gestational age and survival rates for twins among those with pPPROM, the survival rate to live birth of at least one twin remained high for patients who chose expectant management.
Society for Maternal-Fetal Medicine Consult Series #72: Twin-twin transfusion syndrome and twin anemia-polycythemia sequence.
Am J Obstet Gynecol
October 2024
Article Synopsis
- * The text emphasizes the need for proper monitoring and management of twin-twin transfusion syndrome and twin anemia-polycythemia sequence in monochorionic pregnancies, with specific ultrasound surveillance recommendations starting at 16 weeks.
- * The Society for Maternal-Fetal Medicine recommends routine assessments and advanced treatments like fetoscopic laser surgery for severe cases of twin-twin transfusion syndrome, depending on the stage of the condition and other factors.
Incidence and risk factors of neonatal peripherally inserted central catheter-related thrombosis: A systematic review and meta-analysis.
Nurs Crit Care
July 2024
Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, China.
Article Synopsis
- Neonatal PICC-related thrombosis is a significant complication in infants that affects their health and safety, leading to unintended removal of catheters.
- This study conducts a systematic review and meta-analysis to evaluate the incidence (pooled incidence of 2%) and risk factors associated with thrombosis in neonates with PICC.
- Identified risk factors include lower extremity insertion sites, younger gestational age, specific health conditions, and prolonged hospital stays, emphasizing the need for careful management in neonatal care.