Severe twin‐to‐twin transfusion syndrome: a new sonographic feature of the placenta

Frisch, Leon; Arava, Jacob; David, H.; Oe, Jaschevatzky; Ballas, S

doi:10.1046/j.1469-0705.1997.10020145.x

Cited by 7 publications

(9 citation statements)

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“…It has been suggested that discordancy in the placental echodensity between the donor and the recipient might be a sign suggestive of TTTS . In the earliest report, severe TTTS was diagnosed on the basis of the discordancy in placenta echodensity .…”

Section: Discussionmentioning

confidence: 99%

Discrepancy in placental echogenicity: a sign of twin anemia polycythemia sequence

Movva

Rijhsinghani

2014

Prenat Diagn

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Twin anemia polycythemia sequence (TAPS) is a form of twin-to-twin transfusion syndrome that occurs very rarely and may not be diagnosed until after delivery. The condition leads to increased risk of perinatal morbidity and mortality. We present two cases of monochorionic diamniotic twins, in which the diagnosis of TAPS was made after documenting a discrepancy in the echodensities of the two portions of the placenta. Postnatal hemoglobin differences between the twins confirmed the diagnosis of TAPS. On the basis of these two cases, it appears that the heterogeneity in placental echogenicity is a sign of TAPS and Doppler measurement of middle cerebral artery peak systolic velocity is helpful for early diagnosis and management with timely delivery.

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Section: Discussionmentioning

confidence: 99%

Discrepancy in placental echogenicity: a sign of twin anemia polycythemia sequence

Movva

Rijhsinghani

2014

Prenat Diagn

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“…Discordant echogenicity between the donor and recipient placenta has been proposed as an additional sonographic sign of TTTS [3]. However, this sonographic finding was also described in a case of a monochorionic-diamniotic twin pregnancy complicated by “stuck twin syndrome” without TTTS [4]; thus, discordant placental echogenicity may not be limited to pregnancies complicated by TTTS.…”

Section: Discussionmentioning

confidence: 99%

Discordant placental echogenicity: a novel sign of impaired placental perfusion in twin-twin transfusion syndrome?

Kusanovic¹,

Romero²,

Gotsch³

et al. 2009

The Journal of Maternal-Fetal & Neonatal Medicine

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Twin-Twin transfusion syndrome (TTTS) is present in approximately 5 to 15% of monochorionic-diamniotic twin pregnancies. A chronic blood flow imbalance through placental vascular anastomoses from the donor to the recipient twin is considered the pathophysiologic mechanism responsible for the development of TTTS. Discordant echogenicity between the donor and recipient placenta has been proposed in a previous case report as an additional sonographic sign of TTTS. Here, we present a case of TTTS with discordant placental echogenicity characterized by a hyperechoic and thicker placental side in the donor twin associated with reduced vascular Doppler signals, histologic lesions suggestive of ischemic changes, and overexpression of anti-angiogenic factors.

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“…We suggest that the different contrast of each placenta reflects its vascularity and perfusion; in this case the smaller underperfused placenta was lighter (hyperechoic) than the placenta with normal perfusion (hypoechoic). Therefore, this sign must be considered unreliable as a diagnostic criterion for twin-to-twin transfusion syndrome 7 .…”

Section: Discussionmentioning

confidence: 99%

“…The prenatal identification by ultrasound of two distinct parts of the same placenta -distinguished by a clear dividing line -in a monochorionic twin pregnancy has been suggested as a new diagnostic sign for twin-to-twin transfusion syndrome 7 . According to this finding, the placenta can sonographically be divided into a hyperechogenic part ('white placenta') belonging to the donor twin, and a hypoechogenic part ('dark placenta') that belongs to the recipient twin.…”

Section: Introductionmentioning

confidence: 99%

Stuck twin syndrome without signs of twin‐to‐twin transfusion

Lees

Schwärzler

Ville

et al. 1998

Ultrasound in Obstet & Gyne

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Twin-to-twin transfusion syndrome represents a dilemma for both diagnosis and management. It has recently been suggested that a difference in contrast on B-mode ultrasound between the placentas is pathognomonic for the syndrome. We describe a case of monochorionic diamniotic twins with normal growth in one twin, the other showing features of stuck twin syndrome. In this case, although the contrast difference between the placentas was marked, twin-to-twin transfusion syndrome was ruled out, rendering this sign unreliable for diagnosis. Furthermore, evaluation of the stuck twin showed excessive adrenal artery flow, a feature that has been described in connection with poor antenatal and neonatal outcome. In this case, serial Doppler ultrasound evaluation of both fetuses enabled optimal timing of delivery.

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Severe twin‐to‐twin transfusion syndrome: a new sonographic feature of the placenta

Cited by 7 publications

References 0 publications

Discrepancy in placental echogenicity: a sign of twin anemia polycythemia sequence

Discrepancy in placental echogenicity: a sign of twin anemia polycythemia sequence

Discordant placental echogenicity: a novel sign of impaired placental perfusion in twin-twin transfusion syndrome?

Stuck twin syndrome without signs of twin‐to‐twin transfusion

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