Fetal medicine: Intrauterine fetal demise following laser treatment in twin‐to‐twin transfusion syndrome

Cavicchioni, O.; Yamamoto, M.; Robyr, R.; Takahashi, Yuichiro; Ville, Y.

doi:10.1111/j.1471-0528.2006.00913.x

Cited by 69 publications

(70 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Three of the cases reported here have already been reported. 15 Single IUFD involved 11 donors and 8 recipients. The median gestational age at IUD was 23 [20][21][22][23][24][25][26][27][28] weeks, and the median interval between IUFD and intrauterine transfusion (IUT) was 12 [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] hours.…”

Section: Resultsmentioning

confidence: 99%

Outcome of anaemic monochorionic single survivors following early intrauterine rescue transfusion in cases of feto‐fetal transfusion syndrome

Quarello

Stirnemann

Nassar

et al. 2008

BJOG

View full text Add to dashboard Cite

Objective To evaluate the outcome of severely anaemic monochorionic (MC) twins surviving the death of their co-twin following early intrauterine rescue transfusion in cases of feto-fetal transfusion syndrome (FFTS).Study design We reviewed all MC pregnancies complicated with FFTS following primary management, in which a single intrauterine fetal death (IUFD) was diagnosed with certainty within 24 hours between January 1999 and December 2006. We included MC survivors who presented ultrasound or Doppler features of fetal anaemia following the death of their co-twin. Intrauterine transfusion (IUT) was given to all survivors who were anaemic.Results Nineteen MC twin pregnancies presented a single intrauterine death (IUD) associated with an anaemic co-twin. Median gestational age at IUD was 23 [20][21][22][23][24][25][26][27][28] weeks. The median interval between IUD and IUT was 12 [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] hours. There were 58% (11/19) healthy survivors. Perinatal death rate was 26% (5/19) including 16% (3/19) intrauterine and 10% (2/19) neonatal deaths. Abnormal prenatal cerebral findings developed in 21% (4/19) cases, always within 1 month after the death of the co-twin. Considering occlusive techniques and other management separately, there were 64% (7/11) and 50% (4/8) healthy survivors, respectively, and perinatal death occurred in 36% (4/11) and 12.5% (1/8) of fetuses, respectively. Prenatal fetal cerebral lesions developed in 9% (1/11) of cases following occlusive techniques and in 37.5% (3/8) of fetuses when managed differently. The median gestational age at delivery in the survivors was 31 [25][26][27][28][29][30][31][32][33][34][35][36][37][38] weeks. ConclusionIn cases of FFTS with single anaemic survivors, early IUT could be offered following extensive counselling and close follow up.

show abstract

Section: Resultsmentioning

confidence: 99%

Outcome of anaemic monochorionic single survivors following early intrauterine rescue transfusion in cases of feto‐fetal transfusion syndrome

Quarello

Stirnemann

Nassar

et al. 2008

BJOG

View full text Add to dashboard Cite

show abstract

“…La muerte de un feto ocurre en cerca del 20% luego del procedimiento, pudiendo afectar a donantes o receptores. Diversos estudios han buscado detectar factores de riesgo preoperatorios para predecirla (16,17,18).…”

Section: Discussionunclassified

Tratamiento Por Fetoscopia Del Síndrome De Transfusión Feto Fetal en Clínica Alemana De Santiago

et al. 2009

Rev. chil. obstet. ginecol.

View full text Add to dashboard Cite

RESUMENAntecedentes: El síndrome de transfusión feto fetal (STFF) afecta el 15% de los gemelares monocoriales y tiene una mortalidad de 90% cuando se diagnostica antes de las 26 semanas. Objetivo: Evaluar el resultado perinatal mediante fotocoagulación con láser por fetoscopia, de las anastomosis vasculares placentarias en pacientes con STFF. The maternal and perinatal outcome is similar to international series and demonstrates feasibility in our country by experienced operators.

show abstract

“…Recent studies report that there is a 10% risk of PPROM with a 10 to 30% risk of fetal death, of at least one of the two twins. 64,76,81,122,132 Another recognized complication of laser treatment is unintentional septostomy of the intertwin membrane. Usually, it can be caused by difficult entry in the uterine cavity close to the donor embryo, where because of the anhydramnios the membrane may not be visible and perforated.…”

Section: Complications Of Laser Treatmentmentioning

confidence: 99%

“…64,89 Fetal MRI after fetal death of one of the twins who were treated with laser for TTTS can detect brain injury much earlier than ultrasound, 64,140,141 and MRI imaging has been suggested by some centers pre and posttreatment for TTTS, and for cases complicated by single twin demise. 64,132,141143 Laser photocoagulation for at least severe cases of TTTS appears to be the best possible option for treatment. However, parents and physicians need to have in mind that TTTS is a very high risk case in terms of perinatal outcomes and that the possibility of death of at least one of the two twins is very high, about 30 to 50% and that even after survival from treatment for TTTS there is a significant risk of long-term neurological impairment ranging from 5 to 20%.…”

Section: Outcome Of Treatment-neonatal Follow-upmentioning

confidence: 99%

Invasive Procedures in Monochorionic Twins

Antsaklis¹,

Antsaklis²

2015

Donald School Journal of Ultrasound in Obstetrics and Gynecology

View full text Add to dashboard Cite

Monochorionic twin pregnancies (MC) are less frequent but they are considered higher risk pregnancies compared to dichorionic pregnancies. As a result, determining the chorionicity of a twin pregnancy is of vital importance for the surveillance and management of the pregnancy. The problem originates from the fact that monochorionic twins have one placenta, and as a result the circulation of the two fetuses is closely related to each other mainly through anastomosis of the placenta. The number and type of anastomosis is of great importance for the course of the pregnancy. Diagnosis of chromosomal abnormalities in such pregnancies requires excellent knowledge of invasive procedures and good clinical skills. Monochorionic twins are at increased risk for unique complications including twin-to-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR), and twin-reversed arterial perfusion (TRAP) sequence. Twin-to-twin transfusion syndrome is a very well known and described complication of mono chorionic twin pregnancies and must be considered and checked in each monochorionic pregnancy. Selective feticide is not a method used very commonly in MC pregnancies, but may be applied in selected cases. For TTTS laser treatment of the anastomosis is a method of choice, but should be performed in centers with experience.

show abstract

Fetal medicine: Intrauterine fetal demise following laser treatment in twin‐to‐twin transfusion syndrome

Cited by 69 publications

References 9 publications

Outcome of anaemic monochorionic single survivors following early intrauterine rescue transfusion in cases of feto‐fetal transfusion syndrome

Outcome of anaemic monochorionic single survivors following early intrauterine rescue transfusion in cases of feto‐fetal transfusion syndrome

Tratamiento Por Fetoscopia Del Síndrome De Transfusión Feto Fetal en Clínica Alemana De Santiago

Invasive Procedures in Monochorionic Twins

Contact Info

Product

Resources

About