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Twin twin transfusion

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https://www.readbyqxmd.com/read/29040903/aplasia-cutis-congenita-as-a-result-of-interstitial-laser-therapy-for-fetal-reduction-in-monochorionic-twins-conservative-approach-and-outcome
#1
Veronica Mugarab-Samedi, Abhay Lodha, Adel ElSharkawy, Essa Al Awad
Monochorionic (MC) twin pregnancies are known to carry a high risk of twin-to-twin transfusion syndrome (TTTS) that could lead to miscarriage and perinatal death. Demise of one fetus is frequently associated with co-fetal death. Fetal reduction by interstitial laser therapy is an effective procedure to prevent this outcome, but it may be associated with significant risks for both mother and fetus. Aplasia Cutis Congenita (ACC) may occur in up to 8% cases of fetal reduction by laser therapy. We report ACC in a preterm infant, a survivor of interstitial laser therapy for fetal reduction in MC pregnancy...
October 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29027307/transient-amniotic-fluid-leakage-after-fetoscopic-laser-photocoagulation-for-twin-twin-transfusion-syndrome
#2
Shiyo Ota, Keisuke Ishii, Hiroshi Kawamura, Aki Mabuchi, Ryo Yamamoto, Shusaku Hayashi, Takeshi Kanagawa, Nobuaki Mitsuda
AIM: Iatrogenic premature rupture of membrane (PROM) is one of the major complications related to fetoscopic laser photocoagulation (FLP) for twin-twin transfusion syndrome (TTTS). However, amniotic fluid leakage (AFL) sometimes spontaneously disappears. This study evaluated the incidence and clinical characteristics of transient AFL after FLP. METHODS: We retrospectively reviewed pregnancies that underwent FLP for TTTS at a single center. Patients with apparent AFL within 2 weeks after FLP were divided into two groups: transient AFL, defined by the disappearance of fluid leakage within a week; and PROM, if AFL persisted continuously for more than a week or premature birth occurred, including miscarriage, within a week of the first symptom of AFL...
October 13, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29024208/does-the-site-of-the-cord-insertion-increase-the-risk-of-adverse-outcome-twin-to-twin-transfusion-syndrome-and-discordant-growth-in-monochorionic-twin-pregnancies
#3
Isabel Couck, Nada Mourad Tawfic, Jan Deprest, Luc De Catte, Roland Devlieger, Liesbeth Lewi
BACKGROUND: It is insufficiently known to what degree the site of the cord insertions influences the risk of a complicated outcome in monochorionic twin pregnancies. OBJECTIVES: The purpose is to examine if the site of cord insertions as determined on prenatal ultrasound scan increases the risk of adverse outcome -defined as fetal or neonatal loss or birth prior to 32 weeks-, twin-to-twin transfusion syndrome (TTTS) and discordant growth. METHODS: We retrospectively studied a consecutive cohort of monochorionic diamniotic twin pregnancies followed from the first trimester...
October 11, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29020780/-selective-feticide-in-monochorionic-twin-pregnancies-with%C3%A2-discordant-fetal-anomalies-management-and-outcome
#4
J Vojtěch, L Hašlík, R Pock, K Běhávková, K Macková, P Hanulíková, H Heřman, L Krofta
OBJECTIVE: To analyze results and outcome after selective feticide for discordant anomalies in monochorionic twins. DESIGN: Prospective cohort study. SETTING: Fetal medicine center, Institute for the Care of Mother and Child, Praha. METHODS: Analysis of outcome of monochorionic pregnancies after intrauterine surgery for structural abnormalities between January 2013 and June 2016. RESULTS: We performed 13 intrauterine operations in monochorionic twins with structural anomalies during the period...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28976606/the-significance-of-placental-cord-insertion-site-in-twin-pregnancy
#5
Erkan Kalafat, Basky Thilaganathan, Aris Papageorghiou, Amar Bhide, Asma Khalil
OBJECTIVE: The aim of this study was to investigate the association between abnormal cord insertion and the development of the twin-specific complications, including birthweight discordance, selective fetal growth restriction (sFGR) and twin-to-twin transfusion syndrome (TTTS). METHODS: A single-center cohort study of twin pregnancies. Abnormal cord insertion was defined as either marginal (cord attachment site less than 2cm to the nearest margin of the placental disc) or velamentous (when the umbilical cord was attached to the membrane before reaching the placental disc with clear evidence of vessels traversing the membranes to connect with the placental disc), as described in placental pathology reports...
October 4, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28971247/severe-gyration-and-migration-disorder-in-fetofetal-transfusion-syndrome-two-case-reports-and-a-review-of-the-literature-on-the-neurological-outcome-of-children-with-lesions-on-neuroimaging
#6
Rudolf Ascherl, Ina Sorge, Ulrich Thome, Franz Wolfgang Hirsch, Annett Bläser, Wieland Kiess, Andreas Merkenschlager
INTRODUCTION: Fetofetal transfusion syndrome is a dreaded cause of morbidity and mortality in monochorionic pregnancies. CASE REPORTS: We present two pairs of twins one of which we have followed for more than 6 years. The donors suffer from cerebral palsy, orofacial, and motor problems, and both are significantly smaller than their recipient twins. Interestingly, cranial MRI revealed medial frontal lobe polymicrogyria, ventriculomegaly, and decreased thickness in both parietal lobes in both donors...
October 2, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28969512/placental-histopathology-differences-and-neonatal-outcome-in-dichorionic-diamniotic-as-compared-to-monochorionic-diamniotic-twin-pregnancies
#7
Eran Weiner, Elad Barber, Ohad Feldstein, Ann Dekalo, Letizia Schreiber, Jacob Bar, Michal Kovo
OBJECTIVE: We aimed to compare the differences in placental histopathology lesions and pregnancy outcome in dichorionic-diamniotic (DCDA) versus uncomplicated monochorionic-diamniotic (MCDA) twin gestations. STUDY DESIGN: Maternal characteristics, neonatal outcome, and placental histopathology reports of all twin deliveries between 24 and 41 weeks were reviewed. Excluded were pregnancies complicated by twin-to-twin transfusion syndrome, twin anemia-polycythemia sequence, selective intrauterine growth restriction, placenta previa, intrauterine fetal death, and malformation...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28965437/midtrimester-isolated-oligohydramnios-in-monochorionic-diamniotic-multiple-gestations
#8
Andrew H Chon, Lisa M Korst, Ryan D Assaf, Arlyn Llanes, Joseph G Ouzounian, Ramen H Chmait
OBJECTIVE: To describe the natural history and perinatal outcomes of monochorionic diamniotic twins with midtrimester isolated oligohydramnios (iOligo). MATERIALS AND METHODS: We performed a retrospective study of iOligo patients who were initially referred for the management of evolving twin-twin transfusion syndrome (TTTS) or selective intrauterine growth restriction (sIUGR). iOligo was defined as a maximum vertical pocket of amniotic fluid of ≤ 2 cm in the iOligo twin's sac and normal fluid level (> 2 and < 8 cm) in the co-twin's sac...
October 1, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28961141/neurological-complications-after-therapy-for-fetal-fetal-transfusion-syndrome-a-systematic-review-of-the-outcomes-at-24-months
#9
Ana Miralles-Gutiérrez, Isidoro Narbona-Arias, Ernesto González-Mesa
OBJECTIVE: The main objective of this study was to review the available scientific evidence about mid-term neurological outcomes in twins after laser therapy for twin-to-twin transfusion syndrome (TTTS). METHODS: A systematic review of studies on neurodevelopmental outcomes (cognition, motor development, communication skills and cerebral palsy) of twins after laser therapy for TTTS was conducted. Outcomes at 24 months of age and the use of validated scales for assessment were the selected criteria...
September 29, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28948639/time-interval-measurements-of-the-ductus-venosus-during-the-early-second-trimester-of-pregnancy-reference-ranges-and-clinical-application
#10
Manaphat Suksai, Chitkasaem Suwanrath, Ounjai Kor-Anantakul, Alan Geater
OBJECTIVES: The aims of this study were to construct reference ranges for the time interval parameters of the ductus venosus during the early second trimester of pregnancy and to demonstrate the clinical utility in various fetal disorders. METHODS: The ductus venosus Doppler measurements of 331 healthy fetuses between 15 and 22 weeks' gestation were analyzed. The systolic time and diastolic time were subdivided into the systolic acceleration time, systolic deceleration time, diastolic acceleration time, and diastolic deceleration time...
September 26, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28935062/no-260-ultrasound-in-twin-pregnancies
#11
Lucie Morin, Kenneth Lim
OBJECTIVE: To review the literature with respect to the use of diagnostic ultrasound in the management of twin pregnancies. To make recommendations for the best use of ultrasound in twin pregnancies. OUTCOMES: Reduction in perinatal mortality and morbidity and short- and long-term neonatal morbidity in twin pregnancies. Optimization of ultrasound use in twin pregnancies. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library in 2008 and 2009 using appropriate controlled vocabulary (e...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28934089/postpartum-hemorrhage-with-transfusion-trends-near-misses-risk-factors-and-management-at-the-scale-of-a-perinatal-network
#12
M Marocchini, J Lauféron, C Quantin, P Sagot
OBJECTIVES: To analyze temporal trends and management of postpartum hemorrhage (PPH) with transfusion and its related maternal near-miss (MNM) cases between 2006 and 2014 and to study risk factors. MATERIAL AND METHODS: This retrospective cohort study from two prospective databases included 156,047 women giving birth in all the maternity hospitals of Burgundy. We analyzed temporal trends and the distribution of PPH with transfusion, the circumstances of transfer of patients between hospitals and factors associated with PPH with transfusion...
May 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28926832/persistent-pulmonary-hypertension-of-the-newborn-in-twin-twin-transfusion-syndrome-a-case-control-study
#13
Manon Gijtenbeek, M C Haak, Derk Jan Ten Harkel, Arjan B Te Pas, Johanna M Middeldorp, Frans J C M Klumper, Nan van Geloven, Dick Oepkes, Enrico Lopriore
BACKGROUND: Persistent pulmonary hypertension of the newborn (PPHN) is associated with severe morbidity and mortality. Twin-twin transfusion syndrome (TTTS) is suggested to increase the risk of PPHN. OBJECTIVES: To describe the incidence of PPHN in TTTS twins and to identify risk factors in TTTS twins for the development of severe PPHN. METHODS: Cases with severe PPHN were extracted from our monochorionic twin database (2002-2016). Severe PPHN was defined as severe hypoxaemia requiring mechanical ventilation and inhaled nitric oxide (iNO) treatment, confirmed by strict echocardiographic criteria...
September 20, 2017: Neonatology
https://www.readbyqxmd.com/read/28925589/recurrent-twin-twin-transfusion-syndrome-rttts-and-twin-anemia-polycythemia-sequence-taps-after-fetoscopic-laser-surgery-fls-size-of-the-cannula-does-matter
#14
Roopali Donepudi, Joost Akkermans, Lovepreet Mann, Frans J Klumper, Johanna M Middeldorp, Enrico Lopriore, Kenneth J Moise, Michael Bebbington, Anthony Johnson, Dick Oepkes, Ramesha Papanna
OBJECTIVES: Optimal outcomes after fetoscopic laser surgery (FLS) for twin-twin transfusion (TTTS) depend on the successful completion of ablation of all placental anastomoses. Our objective was to determine the incidence and risk factors for the occurrence of recurrent TTTS (rTTTS) or twin anemia-polycythemia sequence (TAPS) after FLS, and focusing on the impact of different diameters of the cannula. METHODS: A secondary analysis of prospectively collected data of 666 consecutive patients undergoing laser surgery for TTTS from 2 centers was performed...
September 19, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28918426/aortic-isthmus-flow-recording-predicts-the-outcome-of-the-recipient-twin-after-laser-coagulation-in-twin-twin-transfusion-syndrome
#15
France Leduc, Amélie Delabaere, Roxanne Gendron, Florent Fuchs, Sandrine Wavrant, Marie-Josée Raboisson, Jean-Claude Fouron, François Audibert
INTRODUCTION: The objective was to assess the prognostic value of the systolic flow through the aortic isthmus in monochorionic pregnancies complicated by twin-twin transfusion syndrome (TTTS) treated by placental laser ablation. MATERIAL AND METHODS: Fetal echocardiography and outcome data of 105 cases of TTTS treated by laser photocoagulation of placental anastomoses were reviewed. Hemodynamic parameters were collected before and after treatment. The isthmic systolic index (ISI) was calculated as the peak systolic velocity/systolic nadir ratio...
September 16, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28864011/can-color-difference-on-the-maternal-side-of-the-placenta-distinguish-between-acute-peripartum-twin-twin-transfusion-syndrome-and-twin-anemia-polycythemia-sequence
#16
Lisanne S A Tollenaar, Danny P Zhao, Johanna M Middeldorp, Dick Oepkes, Femke Slaghekke, Enrico Lopriore
OBJECTIVE: To investigate the color difference between two placental shares in monochorionic placentas with acute peripartum twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). METHODS: We evaluated all digital pictures of TAPS, acute peripartum TTTS and a control group of uncomplicated monochorionic placentas examined at our center. We determined the color intensity of the individual placental share on the maternal side of each monochorionic placenta using an image-processing program and calculated the color difference ratio (CDR)...
September 2017: Placenta
https://www.readbyqxmd.com/read/28850167/invasiv-fosterterapi-utvecklas-allt-mer-fr%C3%A3-n-intrauterin-blodtransfusion-till-fetoskopisk-kirurgi-shuntinl%C3%A3-ggning-laserbehandling-och-radiofrekvensablation
#17
Eleonor Tiblad, Sverker Ek, Marius Kublickas, Peter Lindgren
Invasive fetal therapy  Invasive fetal therapy in Sweden consists of fetoscopic interventions to treat twin-to-twin transfusion syndrome (TTS) or twin anemia polycytemia sequence (TAPS) in monochorionic twin or triplet pregnancies and for selective reduction in monochorionic twins complicated by discordant anomalies or severe growth retardation in one fetus. Alternative methods, such as intrafetal laser ablation and radio frequency ablation, are also used for selective reduction and rarely to treat fetal tumors...
August 29, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28835143/neonatal-cerebral-lesions-predict-2-year-neurodevelopmental-impairment-in-children-treated-with-laser-surgery-for-twin-twin-transfusion-syndrome
#18
Ramen H Chmait, Andrew H Chon, Sheree M Schrager, Arlyn Llanes, Anita H Hamilton, Douglas L Vanderbilt
OBJECTIVE: To assess whether postnatally detected cerebral abnormalities are predictive of neurodevelopmental impairment (NDI) in survivors of twin-twin transfusion syndrome (TTTS) that underwent laser surgery. MATERIALS AND METHODS: 99 children treated for TTTS had neurodevelopmental assessment at age 2-years (± 6 weeks). "High-risk survivors" had cerebral imaging in the neonatal period. "High-risk survivors" were defined as: 1) delivered at < 32 weeks; or 2) cerebral imaging clinically indicated...
August 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28764674/arabin-cervical-pessary-for-prevention-of-preterm-birth-in-cases-of-twin-to-twin-transfusion-syndrome-treated-by-fetoscopic-laser-coagulation-the-pecep-laser-randomised-controlled-trial
#19
Carlota Rodó, Sílvia Arévalo, Liesbeth Lewi, Isabel Couck, Bettina Hollwitz, Kurt Hecher, Elena Carreras
BACKGROUND: Fetoscopic LASER coagulation of the placental anastomoses has changed the prognosis of twin-twin transfusion syndrome. However, the prematurity rate in this cohort remains very high. To date, strategies proposed to decrease the prematurity rate have shown inconclusive, if not unfavourable results. METHODS: This is a randomised controlled trial to investigate whether a prophylactic cervical pessary will lower the incidence of preterm delivery in cases of twin-twin transfusion syndrome requiring fetoscopic LASER coagulation...
August 1, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28761987/depression-anxiety-and-mental-health-service-experiences-of-women-with-a-twin-twin-transfusion-syndrome-pregnancy
#20
Lynn Falletta, Rebecca Fischbein, Surya Sruthi Bhamidipalli, Lauren Nicholas
Symptoms of emotional distress during and after pregnancy may be introduced or exacerbated by unexpected medical conditions in the mother or fetus. Twin-twin transfusion syndrome (TTTS), which accounts for 17% of fetal deaths in twins and entails substantial medical uncertainty, may represent a particularly challenging pregnancy experience. Yet, little is known about the impact of TTTS on women's emotional health. We retrospectively surveyed 350 women who experienced a TTTS pregnancy about their experiences at three time points (prior to, during, and after pregnancy) to examine symptoms of anxiety and depression, mental health diagnoses, thoughts of seeking mental healthcare, help received, and preferred mental health services...
July 31, 2017: Archives of Women's Mental Health
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