Oral poster abstractsResults: Medians and ranges of the lung function parameters are shown in table 1. There was a trend to higher SR tot and reduced VC in donor twins. Significant differences were shown with lower FEV1% and lower MEF25 in donor twins. Conclusions: Donor twins show a trend towards reduced VC and signs of airway obstruction. Our observations indicate that intrauterine growth retardation in the first half of pregnancy may have a higher impact on air way dynamics than decreased lung volumes which may be explained by fetal lung growth: the airways are formed during early fetal life and completed by 16-20 weeks of gestational age, whereas alveolar development takes place from around 20 weeks to 2-3 years of age. Objective: Although recently developed therapy of TTTS, fetoscopic laser coagulation of communicating vessels (FLP) has been proved its effectiveness in case of anterior located placenta, it has some difficulty to the purpose achieve the FLP completely. HIFU can be transmitted through tissues and its, focused beam can induce tissue necrosis inside the human body without damaging intervening tissues. The purpose of this study was to investigate whether HIFU exposure is able to make an occlusion of surface blood vessels of the placenta without any adverse effects on the tissue around the target vessel.
OP22.07: Table
Material and method:We constructed a prototype HIFU transducer (focal distance 4cm, frequency 2.2MHz) in combination with an imaging probe (7.5MHz). (1)We investigated the spreading of focused HIFU beam by phantom study. (2)Placentas often normal delivery were used for this experiment with informed consent and placental surface blood vessels (diameter is from 1mm to 2mm)were pretreated with heparin not to form coagulation HIFU exposure was applied to surface blood vessels of the placenta merged in the tank filled with degassed water (intensity of HIFU exposure;2000W,20sec). (3) We investigated HIFU exposed tissue pathologically by HE staining. Result: (1) Spreading of HIFU beam was 1.5mm in diameter and 4mm in deep. (2) The exposed vessel was observed high echoic lesion by ultrasound, and recognized as a tissue with white degeneration by macroscopically. HE staining revealed vacuolar degeneration and coagulative necrosis in the vessels and any other lesion were not observed in the tissue around the vessels. Conclusion: We were able to achieve the selective degeneration of placental surface blood vessels using HIFU exposure without damages of the tissue around the target vessels the in-vitro experiment. HIFU exposure may have a potential for an alternative with FLP as a treatment of tool TTTS. (164) anesthesia were compared. Results: There were no differences in stage, deepest amniotic fluid pool, amnioreduction volume, number of anastomoses or survivors. Under GA, operative times were longer, more IV fluid was used and more major maternal complications occurred, including pulmonary edema, ICU admission & blood transfusion. PPROM and minor complications occurred least in the IVS gr...
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