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Twin twin transfusion

S Akhtar Ali, C Ng, J K Votava-Smith, L M Randolph, P Pitukcheewanont
Generalized arterial calcification of infancy (GACI) is a rare genetic disorder with high infantile mortality, described to be due to ENPP1, and less commonly ABCC6 mutations. Bisphosphonate treatment has been described to improve survival in ENPP1-positive GACI patients, but few studies have described bisphosphonate treatment in ABCC6-positive patients. Without therapy, patients will die before 6 months of age. Our patient is now 3 years old, former recipient twin of twin-to-twin transfusion syndrome (TTTS)...
September 11, 2018: Osteoporosis International
Ladina Rüegg, Margaret Hüsler, Franziska Krähenmann, Giancarlo Natalucci, Roland Zimmermann, Nicole Ochsenbein-Kölble
PURPOSE: Twin-to-twin transfusion syndrome (TTTS) complicates 10-15% of all monochorionic twin pregnancies. Selective laser coagulation of placental anastomoses is the only causal therapy. The aim of this study was to analyze the neonatal survival, the survival rate of at least one child at 6 months of age, and maternal outcome after laser therapy in a Swiss cohort. MATERIAL AND METHODS: Between 2008 and 2014, 39 women were treated with fetoscopic laser procedure due to TTTS...
September 10, 2018: Journal of Maternal-fetal & Neonatal Medicine
Imrana Masroor, Sarah Jeelani, Aliya Aziz, Romana Idrees
Acardiac twin formation is a rare anomaly. It is one of the most extreme complications of monozygotic twin pregnancies. Such occurrences are brought about when a normal twin donates blood to an abnormal twin through its umbilical arteries via vascular anastomoses at the level of the placenta, which is termed as twin reversed arterial perfusion sequence (TRAPS). Twin reversed arterial perfusion sequence is considered a rare variant of twin-to-twin transfusion syndrome. Due to the considerable blood transfer from the healthy twin to the parasitic one, cardiac failure can ensue in the healthy twin...
July 2, 2018: Curēus
Eglantine Hamouni, Corinne Armari, Clémentine Dupuis, Claudine Giroux-Lathuile, Audrey Petit, Dominique Plantaz, Dalila Adjaoud, Amandine Rubio
Beta thalassemia major (βTM) is the most common inherited hemoglobinopathy. Management essentially focuses on preventing and treating complications. Conventional treatment is based on a regular blood transfusion program, and chelation therapy. Management essentially focuses on preventing and treating complications. Severe complications of βTM are very rarely seen in children in Europe. In the context of the migrant crisis, pediatricians will be confronted with the challenge of managing severe complicated βTM...
August 31, 2018: Journal of Pediatric Hematology/oncology
Julie Sommer, Anne-Monique Nuyt, François Audibert, Véronique Dorval, Sandrine Wavrant, Gabriel Altit, Anie Lapointe
OBJECTIVE: To compare short-term and long-term outcomes of preterm infants born at <29 weeks of gestational age (GA) with twin-twin transfusion syndrome (TTTS) treated with laser therapy to preterm twin infants without TTTS. DESIGN: Retrospective case-control study comparing 33 preterm TTTS twins to 101 preterm diamniotic-dichorionic (di-di) twins born at our institution between 2006 and 2015. RESULTS: GA at birth were 26.4 ± 1.4 weeks (TTTS) and 26...
September 3, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
L Grondin-Depraetre, M Soussoko, S Gisbert, O Morel, C Bertholdt
OBJECTIVES: In recent years, active neonatal care in case of prematurity leads to an increase of cesarean delivery rate. Data remains sparse on maternal morbidity induced by preterm cesareans and especially before 32 weeks of gestation. The main aim of this study was to evaluate per-partum maternal morbidity in case of cesarean performed before 32 week of gestation. As secondary objectives, we assessed post-partum maternal morbidity and factors associated with maternal morbidity. METHODS: This is a retrospective single-center study conducted in a tertiary care unit between 2014 and 2016 including cesareans performed before 32 week of gestation in the study period...
August 30, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Kurt Hecher, Helena M Gardiner, Anke Diemert, Peter Bartmann
Twin-to-twin transfusion syndrome typically occurs in the second trimester in 10-15% of monochorionic twin pregnancies. Vascular anastomoses of monochorionic placentae are the underlying cause of the development of the syndrome. If a blood flow imbalance occurs, one fetus becomes the so-called donor twin and the other the recipient. If untreated, perinatal mortality is 80-90%. Fetoscopic laser coagulation of the vascular anastomoses destroys the cause of the syndrome and leads to dual twin survival rates of around 70% and more than 90% of pregnancies with at least one survivor...
July 2018: Lancet Child & Adolescent Health
Laura Sienas, Trevor Miller, Juliana Melo, Herman Hedriana
Hyperreactio luteinalis (HL) is a rare benign complication of pregnancy that is characterized by progressive ovarian enlargement and hyperandrogenism. We present a case of a 30-year-old woman with a spontaneous monochorionic diamniotic twin pregnancy who presented with early-onset preeclampsia, concern about possible twin-twin transfusion syndrome, and bilateral enlarged ovarian masses. Both ovaries had multiple thin-walled unilocular cysts; one ovary measured 17.9 × 17.5 × 9.1 cm and the other 12...
July 2018: Case Reports in Women's Health
Katrine Vasehus Schou, Ane Vibeke Lando, Charlotte Kvist Ekelund, Lisa Neerup Jensen, Connie Jørgensen, Lone Nikoline Nørgaard, Line Rode, Kirsten Søgaard, Ann Tabor, Karin Sundberg
INTRODUCTION: We sought to assess the incidence of severe neurodevelopmental impairment (NDI) in monochorionic twins treated for twin-twin transfusion syndrome (TTTS) and compare it to the incidence in uncomplicated monochorionic twins. MATERIAL AND METHODS: We included TTTS pregnancies treated by fetoscopic selective laser coagulation (FSLC) or umbilical cord occlusion (UCO) in 2004-2015. Primary outcome was severe NDI defined as cerebral palsy, bilateral blindness or bilateral deafness (ICD-10 diagnoses), and severe cognitive and/or motor delay (assessed by the Ages and Stages Questionnaires [ASQ])...
August 27, 2018: Fetal Diagnosis and Therapy
Adeline Bailly, Hervé Sartelet
No abstract text is available yet for this article.
August 14, 2018: Annales de Pathologie
Arpitha Chiruvolu, Yahya Daoud, Robert W Inzer
BACKGROUND: The very preterm infants of twin births may particularly benefit from delayed cord clamping (DCC) as the likelihood of unfavorable outcome is greater compared to singletons. Unfortunately, there is paucity of available information regarding safety and efficacy of DCC in this group. OBJECTIVE: To report the clinical consequences of delayed cord clamping (DCC) in very preterm twins, born between 230/7 and 316/7 weeks gestation. STUDY DESIGN: In this pre and post intervention retrospective cohort study, we compared 30 very preterm infants born from 15 twin deliveries during historic study period to 32 very preterm infants born from 16 twin deliveries during DCC study period...
September 2018: Early Human Development
Filomena Giulia Sileo, James M N Duffy, Rosemary Townsend, Asma Khalil
The recent investigation of variation in outcome reporting in studies of twin-to-twin transfusion syndrome has highlighted the problem of variable and inconsistently defined outcome reporting in studies of twin-to-twin transfusion syndrome (TTTS).(1) Similar heterogeneity in outcome reporting has been identified across women's and newborn health including pre-eclampsia, childbirth trauma and endometriosis.(2-8) This article is protected by copyright. All rights reserved.
August 6, 2018: Ultrasound in Obstetrics & Gynecology
Allison R Walker, Bethany T Waites, Aaron B Caughey
BACKGROUND: Compared to singleton pregnancies, small for gestational age (SGA) and twin gestations experience adverse maternal and neonatal outcomes. Specific data regarding outcomes in late preterm SGA twin gestations are lacking. OBJECTIVE: Our study sought to compare pregnancy outcomes of late preterm (≥ 34 and < 37 weeks) SGA twins versus singletons. Additionally, we sought to stratify the comparisons by < 10%ile and < 5%ile categories. STUDY DESIGN: In this retrospective cohort of 1...
August 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
Christie Bolch, Michael Fahey, Dinah Reddihough, Katrina Williams, Susan Reid, Angela Guzys, Stephen Cole, Andrew Edwards, Alison Fung, Ryan Hodges, Ricardo Palma-Dias, Mark Teoh, Susan Walker
BACKGROUND: Twin-to-twin transfusion syndrome (TTTS) is a serious complication of 10-15% of twin or triplet pregnancies in which multiple fetuses share a single placenta. Communicating placental vessels allow one fetus (the donor) to pump blood to the other (the recipient). Mortality rates without intervention are high, approaching 100% in some series, with fetal deaths usually due to cardiac failure. Surgical correction using laser photocoagulation of communicating placental vessels was developed in the 1980s and refined in the 1990s...
August 1, 2018: BMC Pediatrics
Allan Javaux, David Bouget, Caspar Gruijthuijsen, Danail Stoyanov, Tom Vercauteren, Sebastien Ourselin, Jan Deprest, Kathleen Denis, Emmanuel Vander Poorten
PURPOSE: Smaller incisions and reduced surgical trauma made minimally invasive surgery (MIS) grow in popularity even though long training is required to master the instrument manipulation constraints. While numerous training systems have been developed in the past, very few of them tackled fetal surgery and more specifically the treatment of twin-twin transfusion syndrome (TTTS). To address this lack of training resources, this paper presents a novel mixed-reality surgical trainer equipped with comprehensive sensing for TTTS procedures...
July 27, 2018: International Journal of Computer Assisted Radiology and Surgery
Laura Sotillo, Maria De la Calle, Fernando Magdaleno, Jose Luis Bartha
OBJECTIVE: This is a prospective observational study whose goal was to compare the effectiveness of carbetocin and oxytocin for prevention of postpartum hemorrhage (PPH) when they are administered in twin pregnancies undergoing a cesarean section. DESIGN: We enrolled 166 twin pregnancies at term undergoing elective or emergency cesarean section. We compared the effect of a single 100 µg dose of carbetocin with the use of oxytocin as a protocol (20 IU in Ringer lactate 500 ml in 10-15 min)...
July 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
Maurício Mendes Barbosa, Eduardo Félix Martins Santana, Hérbene José Figuinha Milani, Julio Elito Júnior, Edward Araujo Júnior, Antônio Fernandes Moron, Luciano Marcondes Machado Nardozza
Objective: To evaluate the initial maternal and perinatal outcomes of fetoscopic laser photocoagulation for the treatment of twin-to-twin transfusion syndrome (TTTS) in a referral center in Brazil. Methods: This prospective observational study analyzed 24 fetoscopic laser photocoagulation procedures at 18-26 weeks of gestation. TTTS severity was determined using the Quintero classification. Blood vessels that crossed the interamniotic membrane were nonselectively photocoagulated...
July 2018: Obstetrics & Gynecology Science
Federico Prefumo, Eric Jauniaux
No abstract text is available yet for this article.
August 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Emily J Camm, Kimberley J Botting, Amanda N Sferruzzi-Perri
The development of the fetal heart is exquisitely controlled by a multitude of factors, ranging from humoral to mechanical forces. The gatekeeper regulating many of these factors is the placenta, an external fetal organ. As such, resistance within the placental vascular bed has a direct influence on the fetal circulation and therefore, the developing heart. In addition, the placenta serves as the interface between the mother and fetus, controlling substrate exchange and release of hormones into both circulations...
2018: Frontiers in Physiology
Lauren Nicholas, Rebecca Fischbein, Lynn Falletta, Kristin Baughman
Objective: The aim of this study was to assess patient experiences when reporting symptoms of twin-twin transfusion syndrome (TTTS) to their health-care providers. Methodology: The study utilized an online, retrospective survey of women, over the age of 18, who were living in the United States at the time of their pregnancy and had completed a TTTS pregnancy. Results: Three hundred sixty-seven cases were included for analysis. Nearly half of the respondents (45...
June 2018: Journal of Patient Experience
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