Pseudoamniotic Band Syndrome: A rare complication of monochorionic triplets with twin‐to‐twin transfusion syndrome

Shamshirsaz, Amirhoushang A.; Shamshirsaz, Alireza A.; Nayeri, Unzila A.; Bahtiyar, Mert O.; Belfort, Michael A.; Campbell, Winston A.

doi:10.1002/pd.2895

Cited by 10 publications

(8 citation statements)

References 11 publications

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“…The survival rates without neurological complications at 28 days of age were 74% for DT cases and 86% of MT triplet cases. One neonate required surgical treatment for a pseudo‐amniotic band syndrome around an ankle due to the entrapment of the dividing membrane subsequent to intentional septostomy during FLP (case 1; Table ) . A color dye injection test of the chorionic vessels was performed for four DT cases and six MT cases, in which all triplets involved in FFTS resulted in live‐birth.…”

Section: Resultsmentioning

confidence: 99%

Perinatal outcome after laser surgery for triplet gestations with feto-fetal transfusion syndrome

et al. 2014

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Section: Resultsmentioning

confidence: 99%

Perinatal outcome after laser surgery for triplet gestations with feto-fetal transfusion syndrome

et al. 2014

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“…Even though we examined all babies and abortuses delivered in our hospital, this incidence could still be under-estimated, as we did not have the chance to examine babies who were delivered elsewhere. In the English literature, there were 25 cases of PABS reported previously [1,2,3,4,5,6,7], of which only 12 cases had clinical details. These 12 cases were reviewed together with our 3 cases (table 1).…”

Section: Discussionmentioning

confidence: 99%

Pseudoamniotic Band Syndrome after In Utero Intervention for Twin-to-Twin Transfusion Syndrome: Case Reports and Literature Review

Ting

Lao²,

Law³

et al. 2015

Fetal Diagn Ther

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Pseudoamniotic band syndrome (PABS) is a rare iatrogenic complication that arises after invasive procedures in monochorionic twins. We report 3 cases of PABS, 2 after fetoscopic laser photocoagulation and 1 after bipolar cord coagulation. Two cases were detected antenatally by ultrasound; out of the two, one underwent successful fetoscopic release of amniotic band, which is the first report in twin pregnancy to our knowledge. In our centre, the incidence of PABS was found to be 2%. There were 25 cases of PABS reported previously, of which 12 cases with clinical details were reviewed together with our 3 cases. The fetal limbs were involved in all 15 cases, leading to constriction or amputation. The umbilical cord was involved in 2 cases, resulting in fetal death in one and pregnancy termination in the other. Antenatal detection of PABS is rare (27%; 4/15) as this requires a high index of suspicion. Serial postoperative targeted ultrasound surveillance of the fetal limbs and umbilical cord is necessary, particularly when features of septostomy or chorioamniotic membrane separation are found. Colour Doppler examination for the perfusion of the affected limb should be performed when PABS is detected. Fetoscopic release of amniotic band could salvage the fetal limb from amputation when impaired blood flow is detected.

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“… 4 10 Unfortunately, data describing the benefits and risks of laser photocoagulation in monochorionic triplets with fetofetal transfusion has been limited to case report and small case series. 8 9 11 12 13 14 15 16 17 18 Here, we describe two additional cases of monochorionic-triamniotic triplets with severe fetofetal transfusion (Quintero stages 3 and 4, respectively) that underwent laser photocoagulation of the communicating placental vessels before 22 weeks gestation.…”

Section: Discussionmentioning

confidence: 99%

Fetofetal Transfusion Syndrome in Monochorionic-Triamniotic Triplets Treated with Fetoscopic Laser Ablation: Report of Two Cases and A Systematic Review

Blumenfeld

Shamshirsaz

Belfort

et al. 2015

AJP Rep

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Objective This study aims to determine the clinical outcomes of monochorionic-triamniotic (MT) pregnancies complicated by severe fetofetal transfusion undergoing laser photocoagulation. Study Design We report two cases of MT triplets complicated by fetofetal transfusion syndrome (FFTS) and a systematic review classifying cases into different subtypes: MT with two donors and one recipient, MT with one donor and two recipients, MT with one donor, one recipient, and one unaffected triplet. The number of neonatal survivors was analyzed based on this classification as well as Quintero staging. Results A total of 26 cases of MT triples complicated by FFTS were analyzed. In 56% of the cases, the FFTS involved all three triplets, 50% of whom had an additional donor and 50% an additional recipient. Among the 24 cases that survived beyond 1 week after the procedure, the average gestational age of delivery was 29.6 weeks, and the average interval from procedure to delivery was 10.1 weeks. The overall neonatal survival rate was 71.7%, with demises occurring equally between donor and recipient triplets. Overall neonatal survival including survival of at least two fetuses occurred with equal frequency between the different groups. Conclusion Significant neonatal survival can be achieved in most cases of MT triplets with FFTS.

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Pseudoamniotic Band Syndrome: A rare complication of monochorionic triplets with twin‐to‐twin transfusion syndrome

Cited by 10 publications

References 11 publications

Perinatal outcome after laser surgery for triplet gestations with feto-fetal transfusion syndrome

Perinatal outcome after laser surgery for triplet gestations with feto-fetal transfusion syndrome

Pseudoamniotic Band Syndrome after In Utero Intervention for Twin-to-Twin Transfusion Syndrome: Case Reports and Literature Review

Fetofetal Transfusion Syndrome in Monochorionic-Triamniotic Triplets Treated with Fetoscopic Laser Ablation: Report of Two Cases and A Systematic Review

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