Twin pregnancy: case reports illustrating variations in transfusion syndrome

Braat, D.D.M.; Exalto, N.; Bernardus, Rob E.; Arts, N.F.T.; Rajnherc, J. R.

doi:10.1016/0028-2243(85)90136-4

Cited by 8 publications

(3 citation statements)

References 9 publications

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“…Twenty-five pregnancies were available for analysis (table 3). Three cases (9,15,19) were from the literature [15][16][17]. Cases 2 [18], 16 [19] and 18 [11] were analyzed in detail elsewhere.…”

Section: Resultsmentioning

confidence: 99%

Discordant Fetal Growth Patterns in Monochorionic Twin Pregnancies Described by Simple Algebraic Relations

Umur

Gemert²,

Schaap³

et al. 2003

Fetal Diagn Ther

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Objective: To test whether twin-twin transfusion syndrome (TTTS) and non-TTTS cases that were suspect but not confirmatory for developing the syndrome (non-TTTS-with-symptoms) have discordant fetal growth patterns that correlate with our previously derived algebraic relations. Methods: In 25 monochorionic twin pregnancies, fetal growth was determined by standard ultrasonography. The difference between estimated fetal weights (dEFW) as well as the difference divided by the average of the two weights, the difference average ratio (DAR), were fitted to the predicted trends of discordant fetal growth for TTTS and non-TTTS pregnancies. The best fits were compared with the clinical data. Results: Out of 13 TTTS cases, dEFW analysis correctly correlated with 8 (62%) and DAR analysis correctly with 10 (77%). Out of 12 non-TTTS-with-symptoms cases, dEFW analysis correctly correlated with 7 (58%) and DAR analysis correctly with 9 (75%). If TTTS correlated best, dEFW analysis was correct in 8/12 (67%), and DAR analysis in 10/11 (91%) cases. If non-TTTS correlated best, dEFW analysis was correct in 7/9 (78%), and DAR analysis in 9/12 (75%). The likelihood ratios of TTTS and non-TTTS were 1.9 and 0.26, respectively, with dEFW analysis, and 9.2 and 0.31 with DAR analysis. Conclusion: The simple algebraic relations derived to identify trends of fetal discordant growth show evidence that clinical TTTS and non-TTTS manifestations are quantifiable. The relations may contribute to future risk stratification in monochorionic twin pregnancies, e.g., by prospectively distinguishing between cases that will develop TTTS and those that will not, despite presenting with symptoms.

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Section: Resultsmentioning

confidence: 99%

Discordant Fetal Growth Patterns in Monochorionic Twin Pregnancies Described by Simple Algebraic Relations

Umur

Gemert²,

Schaap³

et al. 2003

Fetal Diagn Ther

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“…Intrauterine death of 1 fetus with uncomplicated con tinuation of the pregnancy in the first trimester is very common, about 60% [1]. In the second and third trimes ter it is less common (0.5-6.8%), but more serious for the surviving one [2][3][4][5][6].…”

Section: Commentmentioning

confidence: 99%

“…The incidence of twin delivery in western Europe is 1:80 (1.2%) [ 1 ]. Death of one twin may have considerable consequences for the surviving one.…”

Section: Introductionmentioning

confidence: 99%

Death of One Twin Followed by Extremely Variable Flow Velocity Waveforms in the Surviving Fetus

Lander

Oosterhof²,

Aarnoudse³

1993

Gynecol Obstet Invest

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Intrauterine death of one fetus after the second trimester in a twin pregnancy, with continuation of the pregnancy is a rare complication. The risks of morbidity and mortality for the surviving fetus are high. A 32-year-old woman was admitted to the antenatal ward at 27 weeks gestation because of intrauterine death of one twin. During the first 24 h after the death of one twin, Doppler ultrasound assessment showed a remarkable variability in flow velocity waveforms in the umbilical artery of the surviving fetus. Changes from reversed to normal end-diastolic flow velocities were recorded within 6 min. These findings are explained by twin-to-twin transfusion due to intravascular blood pressure changes, or by release of vasoactive substances by the dead fetus.

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