Sectio Parva for Fetal Preservation

Bruner, Joseph P.; Wheeler, Thomas; Bliton, Mark J.

doi:10.1159/000020932

Cited by 3 publications

(2 citation statements)

References 10 publications

(12 reference statements)

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“…Laser dichorionization of the placenta can protect the normal fetus should its anomalous co-twin dies, but it does not stop the progressive polyhydramnios that threaten the whole pregnancy [10]. Transabdominal removal of abnormal fetus, so called sectio parva, has not been widely practiced due to its invasiveness [11]. Therefore, surgical vascular occlusion of the anomalous fetus is the most reasonable option.…”

Section: Discussionmentioning

confidence: 99%

In Utero Bipolar Diathermy to Salvage a Phenotypically Normal Fetus in 45,X/46,XY Heterokaryotypic Monochorionic Twins

Wataganara¹,

Uschararattanasopon²,

Phatihattakorn³

et al. 2012

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Heterokaryotypic monozygotic twins are rare. We report a set of monochorionic diamniotic twins complicated with lethal malformations and hydrops in one fetus at menstrual age of 16 weeks’. Sonographic appearances and genetic am-niocentesis result suggested for 45,X and 46,XY heterokaryotypic twins. Coexisting polyhydramnios found in the sac of severely malformed 45,X fetus threatened miscarriage and premature delivery. To salvage the phenotypically normal male fetus, the hydropic 45,X co-twin was selectively terminated by occlusion of its umbilical cord with bipolar dia-thermy. Complete cessation of funicular flow was achieved, resulting in normalization of total amniotic fluid volume. A healthy 2200-gram baby boy was born at 38 weeks’. His neurodevelopment was intact at 2 years of age. His physical examination was significant for slight growth delay (15 percentiles), with 6% of 45,X mosaicism found in his peripheral blood. Owing to the rarity of the cases, limited data is available regarding an optimal treatment for heterokaryotypic monochorionic twins with discordant lethal malformation. Intrauterine intervention may be offered should demise or permanent disabilities are imminent to the apparently normal fetus

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Section: Discussionmentioning

confidence: 99%

In Utero Bipolar Diathermy to Salvage a Phenotypically Normal Fetus in 45,X/46,XY Heterokaryotypic Monochorionic Twins

Wataganara¹,

Uschararattanasopon²,

Phatihattakorn³

et al. 2012

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show abstract

“…52 Open hysterotomy with removal of the anomalous twin (sectio parva) has also been performed but is largely of historical interest because of high maternal morbidity, including abruption placenta, preterm labor, and pulmonary edema associated with tocolysis. 53 Direct injection of toxic substances into the cord of the anomalous twin is not recommended because of the risk of inadvertent transmigration of the infusate into the pump twin.…”

Section: Twin Reversed Arterial Perfusion Sequencementioning

confidence: 99%

Fetal Surgery

Kunisaki

Jennings

2008

J Intensive Care Med

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Fetal surgery has emerged from the realm of medical curiosity into an exciting, multidisciplinary specialty now capable of improving patient outcomes for a wide variety of diseases. Recent advances allow prenatal providers to both accurately diagnose and treat many fetal anomalies while maintaining maternal safety. As the initial postnatal health care providers to the majority of these newborns, neonatologists need to be familiar with some of the more recent state-of-the-art procedures currently being used. In this review, the authors discuss the prenatal evaluation process and various operative approaches (ie, open hysterotomy, fetoscopy, and percutaneous) to conduct fetal surgery. They then analyze the effectiveness of some of the more established and experimental prenatal therapies that are being performed for a number of fetal anomalies, including twin-twin transfusion syndrome, thoracic malformations, airway obstruction, congenital diaphragmatic hernia, myelomeningocele, and aortic valve stenosis.

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Fetal Surgery

Kunisaki¹,

Jennings²

2008

Operative Obstetrics

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Sectio Parva for Fetal Preservation

Cited by 3 publications

References 10 publications

In Utero Bipolar Diathermy to Salvage a Phenotypically Normal Fetus in 45,X/46,XY Heterokaryotypic Monochorionic Twins

In Utero Bipolar Diathermy to Salvage a Phenotypically Normal Fetus in 45,X/46,XY Heterokaryotypic Monochorionic Twins

Fetal Surgery

Fetal Surgery

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