Feto-fetal Transfusion Syndrome

Galéa, P; Scott, Jean M.; Goel, K M

doi:10.1097/00006254-198307000-00013

Cited by 7 publications

(10 citation statements)

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“…This condition re sults in a wide range of fetal and maternal consequences [2], In relatively less severe cases, polyhydramnios is moderate in the larg er twin and oligohydramnios is mild in the smaller one. The diagnosis is based on weight and hematocrit discrepancies at birth [3] and the pediatric outcome is almost always favor able.…”

Section: Introductionmentioning

confidence: 99%

Twin-to-Twin Transfusion Syndrome: Selective Feticide by Embolization of the Hydropic Fetus

et al. 1995

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To improve the outcome of severe twin-to-twin transfusion syndrome with 1 hydropic fetus and to prevent ischemic sequelae in the survivor, we developed a technique of selective feticide by vascular embolization of the most severely damaged twin. Acute second trimester polyhydramnios occurred in 4 biamniotic monochorial twin pregnancies, with 1 fetus normal on ultrasound but the other severely damaged by hydrops and hypertrophic hypokinetic cardiomyopathy. The hydropic fetus underwent embolization using a bolus of histoacryl injected into the umbilical vein and fetal heart under ultrasound guidance. In 1 triplet pregnancy with a set of monochorial fetuses, premature labor occurred at 26 weeks, 2 weeks after embolization, and there were 2 neonatal deaths. The 3 other cases resulted in the birth of a normal infant at 31–37 weeks of gestation. This suggests that in twin-to-twin transfusion syndrome with severe polyhydramnios and hydrops of 1 fetus, embolization may salvage the other twin.

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Section: Introductionmentioning

confidence: 99%

Twin-to-Twin Transfusion Syndrome: Selective Feticide by Embolization of the Hydropic Fetus

et al. 1995

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“…A cordocentesis was performed at 20 weeks of gestation on the larger twin. The hematocrit of 47%, more than 3 standard deviations above the norm for 20 weeks of gestation [3], supported the presumptive diagnosis of twin to twin transfusion. A cordocentesis of the small twin was not technically feasible.…”

Section: Case Reportmentioning

confidence: 70%

Diagnosis and Treatment of Twin to Twin Transfusion in the Mid-Second Trimester of Pregnancy

Weiner

1987

Fetal Diagn Ther

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Acute hydramnios in the second trimester of pregnancy associated with twin to twin transfusion is a rare and usually disastrous complication. Few infants survive the neonatal period. We report a case of acute hydramnios prior to 20 weeks of gestation secondary to twin to twin transfusion documented by fetal blood samples obtained using cordocentesis. Selective fetacide was performed using a new procedure after a pericardial effusion had failed. The hydramnios resolved and the surviving co-twin was delivered at term.

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“…This hypothesis is supported by the fact that the hydramnios is apparent in the amnion of the recipient twin only. The donor twin, with reduced weight compared to the cotwin, shows a much lower urine excretion resulting in an oligohydramnios in his amnion [2,4,6,11,14]. The reported incidence of acute polyhydramnios ranges from 0.7% up to 6% of all twin pregnancies [1,2,9,10,15].…”

Section: Introductionmentioning

confidence: 99%

“…The reported incidence of acute polyhydramnios ranges from 0.7% up to 6% of all twin pregnancies [1,2,9,10,15]. The extreme perinatal mortality of nearly 100% [1,2,4,6,10,15] results from the addition of two problems: the implications of the feto-fetal transfusion, on the one hand, and the extreme prematurity caused by the hydramnios on the other hand.…”

Section: Introductionmentioning

confidence: 99%

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Acute Polyhydramnios Complicating Twin Pregnancies

Schneider

Vetter

Huch

et al. 1985

Acta genet. med. gemellol.: twin res.

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Abstract. Acute polyhydramnios in the second trimestr is a typical complication in monozygous twin pregnancies. It is caused by a feto-fetal transfusion with anemia on the donor and polycytemia on the recipient twin. Contrary to the chronic hydramnios, there is no increase in malformations. In view of the high mortality rate (100%, according to most authors), the clinical management has to be reconsidered. During the years 1979 to 1983, 10 cases of acute polyhydramnios have been observed at the University Hospital in Zurich. This corresponds to an incidence of 9% in our twin population. All cases investigated were MZ twin pregnancies. With the exception of one patient, who underwent an abortion, all women were hospitalized, had bed rest and received recurrent removals of amniotic fluid and prophylactic tocolysis. The mean gestational age at the time of diagnosis was 23 4/7 weeks and at delivery 30 3/7 weeks. In two cases -one of which is presented in detail -with an unintentional puncture of a placental vessel, the recurrence of the hydramnios did not appear. Eight of 18 newborns survived. No malformations were found. Bed rest, tocolysis and recurrent amniocenteses seem to have a positive influence on the prolongation and outcome of the gestation in acute polyhydramnios.

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Feto-fetal Transfusion Syndrome

Cited by 7 publications

References 0 publications

Twin-to-Twin Transfusion Syndrome: Selective Feticide by Embolization of the Hydropic Fetus

Twin-to-Twin Transfusion Syndrome: Selective Feticide by Embolization of the Hydropic Fetus

Diagnosis and Treatment of Twin to Twin Transfusion in the Mid-Second Trimester of Pregnancy

Acute Polyhydramnios Complicating Twin Pregnancies

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