Vascular limb occlusion in twin-twin transfusion syndrome (TTTS): case series and literature review

Schrey, S; Huber, Agnes; Hecher, Kurt; Quintero, Rubén A.; Alkazaleh, Fawaz; Moise, Kenneth J.; Allbert, John R.; Schneider, Carol; Palermo, Mario; Yinon, Yoav; Chmait, Ramen H.; Windrim, Rory; Ryan, Greg

doi:10.1016/j.ajog.2012.06.005

Cited by 20 publications

(22 citation statements)

References 35 publications

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“…This is a rare complication of MC pregnancy, occurring in around 0.5% of MC twins, with or without TTTS and with or without in utero intervention [11,12]. While the postulated mechanisms include polycythemia, thrombotic emboli, hypertension, vasoconstriction and acute hypoperfusion after intrauterine fetal death of the co-twin, some of these cases could actually be PABS even though amniotic bands might not be observed [11,12]. In all of our 3 cases, amniotic bands were present, thus excluding this differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Pseudoamniotic Band Syndrome after In Utero Intervention for Twin-to-Twin Transfusion Syndrome: Case Reports and Literature Review

Ting

Lao²,

Law³

et al. 2015

Fetal Diagn Ther

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Pseudoamniotic band syndrome (PABS) is a rare iatrogenic complication that arises after invasive procedures in monochorionic twins. We report 3 cases of PABS, 2 after fetoscopic laser photocoagulation and 1 after bipolar cord coagulation. Two cases were detected antenatally by ultrasound; out of the two, one underwent successful fetoscopic release of amniotic band, which is the first report in twin pregnancy to our knowledge. In our centre, the incidence of PABS was found to be 2%. There were 25 cases of PABS reported previously, of which 12 cases with clinical details were reviewed together with our 3 cases. The fetal limbs were involved in all 15 cases, leading to constriction or amputation. The umbilical cord was involved in 2 cases, resulting in fetal death in one and pregnancy termination in the other. Antenatal detection of PABS is rare (27%; 4/15) as this requires a high index of suspicion. Serial postoperative targeted ultrasound surveillance of the fetal limbs and umbilical cord is necessary, particularly when features of septostomy or chorioamniotic membrane separation are found. Colour Doppler examination for the perfusion of the affected limb should be performed when PABS is detected. Fetoscopic release of amniotic band could salvage the fetal limb from amputation when impaired blood flow is detected.

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Section: Discussionmentioning

confidence: 99%

Pseudoamniotic Band Syndrome after In Utero Intervention for Twin-to-Twin Transfusion Syndrome: Case Reports and Literature Review

Ting

Lao²,

Law³

et al. 2015

Fetal Diagn Ther

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“…One TTTS recipient had an amputated lower limb after a congenital limb necrosis, a complication of TTTS reported by others (26). Of the 19 TTTS donors, two (10%) had a diagnosis of cerebral palsy and one of these was ambulant.…”

Section: Resultsmentioning

confidence: 92%

Childhood cardiac outcome after intrauterine laser treatment of twin-twin transfusion syndrome is favourable

et al. 2015

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“…Bebbington et al reported no neonatal or maternal adverse events with the use of RFA in 58 pregnancies 2 . In-utero limb ischemia has been a reported complication of TTTS 3 . However, our case is unique in that it was secondary to RFA and the etiology of ischemia was neovascularization and not occlusion.…”

Section: Limb Arteriovenous Malformation Identified After Radiofrequementioning

confidence: 99%

Limb arteriovenous malformation identified after radiofrequency ablation for selective termination in twin-to-twin transfusion syndrome

Rebarber

Dolin

Fox

et al. 2013

Ultrasound Obstet Gynecol

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Vascular limb occlusion in twin-twin transfusion syndrome (TTTS): case series and literature review

Cited by 20 publications

References 35 publications

Pseudoamniotic Band Syndrome after In Utero Intervention for Twin-to-Twin Transfusion Syndrome: Case Reports and Literature Review

Pseudoamniotic Band Syndrome after In Utero Intervention for Twin-to-Twin Transfusion Syndrome: Case Reports and Literature Review

Childhood cardiac outcome after intrauterine laser treatment of twin-twin transfusion syndrome is favourable

Limb arteriovenous malformation identified after radiofrequency ablation for selective termination in twin-to-twin transfusion syndrome

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