Twin Reduction

Wolfsdorf, Karen

doi:10.1002/9781119556015.ch80

Cited by 2 publications

(4 citation statements)

References 3 publications

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“…31 The technique can be performed through a transrectal approach (60-75 days), via colpotomy (60-95 days) or via a standing flank laparotomy (70-110 days), depending on the operator's preference and the ease of transrectal fetal manipulation. 55 Cranio-cervical dislocation is performed by stabilising the head between the thumb and forefinger and bending the head from side to side. This movement will damage the collateral ligaments attaching the head and neck.…”

Section: Cranio-cervical Dislocation (60-110 Days)mentioning

confidence: 99%

“…This manipulation involves the dislocation of the first cervical vertebra from the cranium, disrupting the ligamentous attachments and severing the spinal cord 31 . The technique can be performed through a transrectal approach (60–75 days), via colpotomy (60–95 days) or via a standing flank laparotomy (70–110 days), depending on the operator's preference and the ease of transrectal fetal manipulation 55 . Cranio‐cervical dislocation is performed by stabilising the head between the thumb and forefinger and bending the head from side to side.…”

Section: Management Of Dizygotic Twinsmentioning

confidence: 99%

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Twin management in the mare: A review

Peere,

van Den Branden,

Papas

et al. 2024

Equine Veterinary Journal

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Twin gestation in the mare is undesirable and can have disastrous consequences. As in many cases, the key to success in twin management lies in a thorough follow‐up and accurate recording of clinical findings in the pre‐breeding examination. A pregnancy diagnosis in the mobility phase is imperative for a good outcome in the event of twin reduction. If a twin gestation is not diagnosed during this early pregnancy stage, several other procedures exist for managing post‐fixation twins (>16 days) with varying degrees of success. Most twin pregnancies are the result of multiple ovulations (dizygotic twins). However, monozygotic twins are also sporadically diagnosed, due to the increasing number of transferred in vitro produced equine embryos. In these cases, the most optimal treatment strategy still needs to be determined. This review provides an overview of the various twin reduction techniques described with the expected prognosis as well as of some less reported techniques with their results. In addition, physiological events and the reduction techniques are demonstrated to the user in virtual 3‐dimensional illustrations.

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Section: Cranio-cervical Dislocation (60-110 Days)mentioning

confidence: 99%

Section: Management Of Dizygotic Twinsmentioning

confidence: 99%

Twin management in the mare: A review

Peere,

van Den Branden,

Papas

et al. 2024

Equine Veterinary Journal

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“…The success of this technique, predominantly performed on bilaterally fixed twin pregnancies, appears to be high because four out of five treated mares delivered a singleton foal 12 . Cranio‐cervical dislocation (CCD) can be performed through a transrectal approach, which is technically challenging, via colpotomy or via a flank laparotomy 19 . Although a success rate of 63% (24/38) has been reported when CCD was performed via flank laparotomy between days 58 and 110 of gestation, 20 this technique is invasive, costly and there is a risk of surgical complications (e.g., formation of seroma or cellulitis at the flank incision) 13 .…”

Section: Introductionmentioning

confidence: 99%

“…12 Craniocervical dislocation (CCD) can be performed through a transrectal approach, which is technically challenging, via colpotomy or via a flank laparotomy. 19 Although a success rate of 63% (24/38) has been reported when CCD was performed via flank laparotomy between days 58 and 110 of gestation, 20 this technique is invasive, costly and there is a risk of surgical complications (e.g., formation of seroma or cellulitis at the flank incision). 13 In 2017, Chopin 16 described two cases of a twin reduction technique in which, between 50 and 60 days of gestation, the rectal ultrasound transducer was used to apply pressure to the neck of one fetus until its heart stopped.…”

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confidence: 99%

Ultrasound‐guided fetal thorax compression to reduce post‐fixation twins in the mare

Arnold,

Stout,

Claes

2024

Equine Veterinary Journal

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BackgroundManagement of twin pregnancy after conceptus vesicle fixation in the horse is challenging because the reduction techniques described are either invasive, difficult to perform or associated with disappointing success rates.ObjectivesTo evaluate the success of transrectal ultrasound‐guided fetal thorax compression for reducing post‐fixation twin pregnancy in mares.Study designRetrospective clinical study.MethodsSixteen mares were presented for twin reduction between 51 and 79 days of gestation. History obtained from the owner and/or referring veterinarian detailed information regarding the mare (age, breed), pregnancy (day of gestation, dizygotic versus monozygotic twins, unilateral versus bilateral fixation), treatment and outcome (one live fetus at discharge; live singleton at foaling) after twin reduction. Transrectal fetal thorax compression was performed under ultrasound guidance by two experienced operators.ResultsOverall 9 of 16 twin pregnancies were successfully reduced and the likelihood of success was significantly higher in dizygotic than monozygotic twins. The procedure was successful in 9 of 10 dizygotic twins but unsuccessful in all six cases of monozygotic twins. Among the dizygotic twins, two mares lost the pregnancy after discharge from the clinic, seven mares delivered a healthy foal of normal size.Main limitationsSmall case number.ConclusionsTransrectal ultrasound‐guided fetal thorax compression is a minimally‐invasive and successful technique for reducing dizygotic twin pregnancies at approximately 2 months of gestation, but does not lead to any live births in cases of monozygotic twins.

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Twin Reduction

Cited by 2 publications

References 3 publications

Twin management in the mare: A review

Twin management in the mare: A review

Ultrasound‐guided fetal thorax compression to reduce post‐fixation twins in the mare

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