Transfusion Syndrome in a Triplet Pregnancy

Pons, Jean-Claude; Olivennes, F.; Fernandez, H.; Ramdin, I.; Mayenga, J.-M.; Bessis, R.; Papiernik, E

doi:10.1017/s0001566000005328

Cited by 13 publications

(5 citation statements)

References 10 publications

(14 reference statements)

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“…In conclusion, monochorionic triamniotic pregnancies are rare and high risk (Adegbite et al, 2005; Enzetami et al, 1997; Fisk et al, 1990; Hayashi et al, 2005; Imaizumi, 2003; Ishii et al, 2006; Leung et al, 2003; Ling et al, 2000; Pons et al, 1990; Rehan et al, 1995). The invasive management of TTTS in monochorionic triplet pregnancies with laser photocoagulation bears the risk of intra-uterine death (Chmait et al, 2009; Diemert et al, 2010; Ishii et al, 2006; Sepulveda et al, 2005; Van Shoubroeck et al, 2004) and TAPS (Lopriore et al, 2007; Robyr et al, 2006).…”

Section: Resultsmentioning

confidence: 98%

“…The rate of TTTS in monochorionic triplet pregnancies is unknown (Sepulveda et al, 2005), while in monochorionic twin pregnancies the incidence is 15% (Sebire et al, 2000). Previous studies have demonstrated high rates of morbidity and mortality associated with TTTS in monochorionic triplet pregnancies (Adegbite et al, 2005;Enzetami et al, 1997;Fisk et al, 1990;Hayashi et al, 2005;Ishii et al, 2006;Leung et al, 2003;Ling et al, 2000;Pons et al, 1990;Rehan et al, 1995). Expectant management (Enzetami et al, 1997;Fisk et al, 1990;Pons et al, 1990), termination of pregnancy (Chasen et al, 2002;Diemert et al, 2010), amnioreduction (Adegbite et al, 2005;Chasen et al, 2002;Hayashi et al, 2005;Leung et al, 2003;Ling et al, 2000;Rehan et al, 1995), and laser photocoagulation (Chmait et al, 2009;Diemert et al, 2010;Ishii et al, 2006;Sepulveda et al, 2005;Van Shoubroeck et al, 2004) have been reported to treat these pregnancies.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Twin–Twin Transfusion Syndrome and Twin Anemia–Polycythemia Sequence in a Monochorionic Triamniotic Pregnancy

et al. 2013

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Twin-twin transfusion syndrome (TTTS) is an antenatal complication of monochorionic multiple gestations. There have been few studies exploring the role of laser photocoagulation or outcomes following treatment in monochorionic triplet pregnancies with TTTS. We present a case where TTTS and twin anemiapolycythemia sequence (TAPS) complicated a monochorionic triplet pregnancy. Following the laser photocoagulation to treat the TTTS between the triplets, an intra-uterine death occurred in one triplet and TAPS developed in the remaining two triplets. Intervention in this case resulted in a 2-week prolongation of pregnancy and a positive outcome for the remaining fetuses. This case and other published data reviewed in this article suggest that laser photocoagulation has a potential role for TTTS in monochorionic triplet pregnancies.

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Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Twin–Twin Transfusion Syndrome and Twin Anemia–Polycythemia Sequence in a Monochorionic Triamniotic Pregnancy

et al. 2013

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“…To our knowledge, only 14 case reports of fetofetal transfusion in triplets have been published and the perinatal morbidity and mortality in these cases seem quite high 2–4,6–14 . They are summarized in Table 1.…”

Section: Discussionmentioning

confidence: 99%

Monochorionic triplet pregnancy complicated by severe fetofetal transfusion

Hayashi¹,

Kikuchi²,

Joshita³

et al. 2005

J of Obstet and Gynaecol

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We report two cases of fetofetal transfusion in monochorionic triamniotic triplet pregnancies. Case 1: At 23 weeks' gestation an amnioreduction was carried out. Three days later, the donor triplet died in utero. Immediately after that, a cardiotocogram of the triplet who had been thought to be unaffected by the fetofetal transfusion, showed a non-reassuring fetal status. Although cesarean section was carried out, none of the triplets survived. Case 2: At 24 weeks' gestation a woman was transferred to our center because of fetofetal transfusion in monochorionic triplets. Cesarean section was carried out. However, the recipient died on the 75th day after birth, and the others had neurological problems. Previous reports on fetofetal transfusion in triplets are very limited. The prognosis of this condition has been reported to be severe, irrespective of chorionicity, gestational age at delivery, maternal age, and parity. When managing a monochorionic or dichorionic triplet pregnancy, serial and careful ultrasound examination is mandatory to find early symptoms of this serious condition.

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“…Clinical Dilemma in Triplet Pregnancy low resistance circulation of the dead fetus, and from the release of autolytic tissue factors from the dead fetus that reach the circulation of the survivor(s). [32][33][34][35][36] Thus, for our analysis to be useful, all reasonable steps must be taken to rule out monozygosity and vascular connections between the jeopardized fetus and one of the healthy fetuses through a careful ultrasound to evaluate for potential vascular connections. Second, it is possible that an intrauterine death in and of itself may create a hostile environment for surviving fetuses, but little is known about such possible risks.…”

Section: Konnikova Et Almentioning

confidence: 99%