Significance of Donor Anuria Differs between Monoamniotic and Diamniotic Twin–Twin Transfusion Syndrome

Schaap, A. H. P.; Wijngaard, Jeroen P. H. M. van den; Nikkels, Peter G. J.; Broek, A.J.M. van den; Snieders, I.; Gemert, Martin J. C. van

doi:10.1016/j.placenta.2006.09.003

Cited by 5 publications

(2 citation statements)

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“…In 318 placentas (94%) one or more A-V anastomoses were present. The only difference in type and number of anastomoses between MA and MC placentas was the almost ubiquitous presence of A-A anastomoses in MA placentas; it was only absent in 1 of 43 monoamniotic placentas 29. This is in contrast with the observation of Bajoria, who reported that MA placentas have significantly greater numbers of both superficial and deep anastomoses than do uncomplicated MC diamniotic pregnancies 30.…”

Section: Vascular Anatomy Of Monochorionic Placentas and Correlation contrasting

confidence: 57%

Pathology of twin placentas with special attention to monochorionic twin placentas

2008

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The risk of perinatal morbidity and mortality in twins is 3-7 times higher than in singletons. In comparison to dichorionic twins, monochorionic twins are at increased risk for perinatal mortality and serious morbidity. In both type of twins growth discordance can occur. Discordant growth of dichorionic twins could be due to differences in placental mass or differences in placental parenchymal lesions, whereas birth weight discordancy in monochorionic twins is caused by placental vascular anastomoses. In this review the different types of complications (acardiac twins, acute and chronic twin-twin transfusion syndrome) due to different combinations of vascular anastomoses are discussed in relation to a computer model developed to gain more insight into the development of the twin-twin transfusion syndrome. The angioarchitecture of 395 monochorionic twin placentas was studied. Mortality was highest in the absence of an arterio-arterial anastomosis (42%) and lowest in the presence of an arterio-arterial anastomosis (15%). If mortality occurred, pregnancies with double mortality usually had an arterio-arterial anastomosis. If pregnancies were complicated by one death, a veno-venous anastomosis is more likely to be present. In conclusion, monochorionic twin pregnancies are a high risk pregnancy with a high chance of both mortality and morbidity; placental characteristics are a major contributor to adverse outcome in these pregnancies.

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Section: Vascular Anatomy Of Monochorionic Placentas and Correlation contrasting

confidence: 57%

Pathology of twin placentas with special attention to monochorionic twin placentas

2008

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“…В то же время в трех крупных рандомизированных исследованиях продемонстрировано, что прогестерон эффекти-вен как средство профилактики преждевремен-ных родов при одноплодной беременности, от-носящейся к группе высокого риска. В последние годы раскрыты основные (прежде всего иммун-ные) механизмы осуществления гестагенами их защитной функции в отношении плода [5,45,46,47,48]. У пациенток, относящихся к группе вы-сокого риска (наличие преждевременных родов в анамнезе или укорочение шейки матки), приме-нение прогестерона в дородовом периоде приво-дило к снижению частоты досрочного заверше-ния беременности на 35% [47,48,49,50,51,52].…”

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