Current Treatment of Twin-to-Twin Transfusion Syndrome

Овсянников, Ф. А.; Романовский, А. Н.

doi:10.18705/2311-4495-2017-4-4-36-42

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…Фетоскопическая лазерная коагуляция анастомозов плаценты по мнению большинства исследователей является оптимальным методом лечения фето-фетального трансфузионного синдрома (ФФТС) при сроке 18-26 недель беременности. Несмотря на впечатляющие успехи в лечении ФФТС, достигнутые в последние 20 лет, фетоскопическая лазерная коагуляция по-прежнему считается слож-ным фетоскопическим вмешательством с высоким риском развития послеоперационных осложнений, таких как преждевременное излитие околоплодных вод, ятрогенная септостомия (разрыв межамниотической мембраны), рецидив ФФТС, ятрогенный синдром анемии-полицитемии, гибель одного плода из двойни, синдром "зеркала" (синдром Баллантайна) [1,2,3,4,5,6,7,8].…”

Section: неонатология и педиатрия / Obstetrics and Gynecologyunclassified

“…Рецидивирование ФФТС после выполнения фетоскопической лазерной коагуляции связано с резидуальными анастомозами, которые представляют собой анастомозы, не выявленные во время операции вследствие их малого диаметра, особенностей локализации, компрессии при выраженном многоводии или реваскуляризированные после недостаточной коагуляции. Рецидив может развиваться как сразу после операции фетоскопической лазерной коагуляции, так и спустя несколько недель [1,5,6,10,11]. Некоторые исследователи предполагают, что причиной рецидива ФФТС могут быть артерио-артериальные и вено-венозные анастомозы, которые после проведения фетоскопической лазерной коагуляции могут становиться однонаправленными, чаще обеспечивая сброс крови в направлении от реципиента к донору [10,11,12].…”

Section: Experience Of Repeated Fetoscopic Laser Coagulation Of Placeunclassified

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Experience of repeated fetoscopic laser coagulation of placental anastomoses in case of recurrence of twin-to-twin transfusion syndrome

Михайлов

Romanovsky

Ovsyannikov

et al. 2018

Transl. med. (Print)

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Recurrence of twin-to-twin transfusion syndrome (TTTS) after fetoscopic laser coagulation (FLC) of placental anastomoses is unfavorable complication. Multiparous woman 34 years old in TTTS stage 2 was performed FLC of 8 arteriovenous anastomoses of the placenta followed by amnioreduction of 1000 ml on the gestational age of 22 weeks and 2 days. At gestational age of 24 weeks 6 days was revealed a recurrence of the TTTS, with considerable polyhydramnion of recipient and anhydramnion of the donor, a repeated FLC of 5 residual placental anastomoses was performed and amnioreduction of 2000 ml at 25 weeks 1 day of gestation. On the fifth day was normalized the amount of amniotic fluid of both fetuses. At 32 weeks of gestation spontaneously was began the birth, the weights of newborns were 1560 and 1600 g, both had Apgar score 8/9. Respiratory therapy continued for 7 hours at the second newborn and for 13 hours at the first newborn girl after transferring to the ICU. The signs of the respiratory failure were not observed. There were no differences between complete blood counts. This clinical case confirms the possibility of effective correction of recurrence TTTS with the help of repeated FLC of placental anastomoses.

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Section: неонатология и педиатрия / Obstetrics and Gynecologyunclassified

Section: Experience Of Repeated Fetoscopic Laser Coagulation Of Placeunclassified

Experience of repeated fetoscopic laser coagulation of placental anastomoses in case of recurrence of twin-to-twin transfusion syndrome

Михайлов

Romanovsky

Ovsyannikov

et al. 2018

Transl. med. (Print)

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Modern aspects of the diagnosis and correction of feto-fetal transfusion syndrome in multifetal monochorial pregnancy

Logutova¹,

Shilkina²

2020

Ross. vestn. akush.-ginekol.

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Anesthesiological Management of Fetoscopic Laser Coagulation of Placental Anastomoses in Twin-to-Twin Transfusion Syndrome

Murieva¹,

Михайлов

Romanovsky

et al. 2019

Transl. med. (Print)

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In this study we presented the analysis of regional anesthesia (epidural and spinal) effectiveness in 72 fetoscopic laser coagulation (FLC) of placental anastomoses, performed in Saint Petersburg Maternity hospital № 17. In 2008 FLC was performed under epidural anesthesia and average time of procedure was 120 minutes, in 2017 according the rising surgical experience the time of procedure reduced to 33 (23–37.5) minutes, that allowed start to use spinal anesthesia. Conclusions: regional methods (epidural and spinal) manage adequate level of anesthesia. Rising surgical experience and reducing the time of procedure to 33 (23–37.5) minutes allowed to use spinal anesthesia successfully. In 29.2 % of cases of regional anesthesia intraoperative arterial hypotension was observed but was successfully corrected by moderate vasopressors doses. No other anesthesiological maternal complications were observed, which confirming safety of regional anesthesia in fetoscopic laser coagulation of placental anastomoses.

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Current Treatment of Twin-to-Twin Transfusion Syndrome

Cited by 4 publications

References 11 publications

Experience of repeated fetoscopic laser coagulation of placental anastomoses in case of recurrence of twin-to-twin transfusion syndrome

Experience of repeated fetoscopic laser coagulation of placental anastomoses in case of recurrence of twin-to-twin transfusion syndrome

Modern aspects of the diagnosis and correction of feto-fetal transfusion syndrome in multifetal monochorial pregnancy

Anesthesiological Management of Fetoscopic Laser Coagulation of Placental Anastomoses in Twin-to-Twin Transfusion Syndrome

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