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Amniotic fluid transfusion

Courtney Stanley Sundin, Lauren Bradham Mazac
Amniotic fluid embolism (AFE) is a rare but serious and potentially deadly complication of pregnancy that is unpreventable and unpredictable. Most AFE events occur during labor; however, approximately one third happen during the immediate postpartum period. Presentation is abrupt and thought to be an abnormal response to fetal materials entering maternal circulation through the placental insertion site. Care providers must recognize the signs and symptoms of AFE and react quickly in effort to treat potential complications...
October 13, 2016: MCN. the American Journal of Maternal Child Nursing
Liran Hiersch, Mayan Eitan, Eran Ashwal, Boaz Weisz, Benny Chayen, Shlomo Lipitz, Yoav Yinon
OBJECTIVE: To estimate the risk for twin anemia-polycythemia sequence (TAPS) and adverse perinatal outcome in monochorionic diamniotic (MCDA) twin pregnancies with amniotic fluid discordance (AFD). METHODS: Retrospective cohort study of 34 MCDA pregnancies with AFD (intertwin difference of ≥3 cm in maximal vertical pocket measurement) without meeting the criteria for twin to twin transfusion syndrome (TTTS) or selective intrauterine growth restriction (sIUGR)...
October 12, 2016: Prenatal Diagnosis
Ramen H Chmait, Eftichia V Kontopoulos, Andrew H Chon, Lisa M Korst, Arlyn Llanes, Rubén A Quintero
OBJECTIVES: Amniopatch is a proposed treatment of iatrogenic preterm premature rupture of membranes (iPPROM). We studied characteristics associated with successful amniopatch treatment of iPPROM after fetoscopic laser surgery for twin-twin transfusion syndrome. METHODS: Patients with iPPROM within 15 days of laser surgery treated with an amniopatch were studied. Factors associated with amniopatch success (i.e. cessation of leakage with normalization of amniotic fluid volume) were tested univariately and in multivariate logistic regression models...
August 10, 2016: Journal of Maternal-fetal & Neonatal Medicine
K Ozawa, R Sugibayashi, S Wada, M Sumie, K Ishii, T Murakoshi, M Nakata, Y Ito, H Sago
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
Amirhossein Moaddab, Ahmed A Nassr, Jimmy Espinoza, Rodrigo Ruano, Zhoobin H Bateni, Amir A Shamshirsaz, George T Mandy, Stephen E Welty, Hadi Erfani, Edwina J Popek, Michael A Belfort, Alireza A Shamshirsaz
Twin anemia polycythemia sequence (TAPS) is defined by significant intertwin hemoglobin discordance without the amniotic fluid discordance that characterizes twin-twin-transfusion syndrome (TTTS) in monochorionic twin pregnancies. TAPS is an uncommon condition which can either occur spontaneously, or following fetoscopic laser ablation for TTTS. This complication is thought to result from chronic transfusion through very small placental anastomoses; however, the pathogenesis of TAPS remains unknown. Consequently, there is no consensus in the management of TAPS...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Hiroshi Kawamura, Keisuke Ishii, Aki Mabuchi, Ryo Yamamoto, Shusaku Hayashi, Nobuaki Mitsuda
AIM: To evaluate the incidence of twin-twin transfusion syndrome (TTTS) and the perinatal outcome at 28 days of age in monochorionic diamniotic (MCDA) pregnancies complicated with isolated polyhydramnios (I-Poly) and isolated oligohydramnios (I-Oligo) diagnosed < 26 weeks of gestation. METHODS: This was a retrospective study of women with MCDA pregnancies diagnosed with I-Poly or I-Oligo before 26 weeks of gestation over a period of six years. The incidence of subsequent TTTS and neonatal outcome in terms of intact survival (IS) at 28 days of age were evaluated...
August 24, 2016: Journal of Obstetrics and Gynaecology Research
Warwick B Dunn, J William Allwood, Tim Van Mieghem, R Katie Morris, Fiona L Mackie, Caroline E Fox, Mark D Kilby
INTRODUCTION: Twin-twin transfusion syndrome (TTTS) complicates 15% of monochorionic twin pregnancies, often being associated with recipient cardiac dysfunction. Untreated, it has a fetal mortality rate of at least 90%; although treatment by fetoscopic laser coagulation significantly improves prognosis. Measurement of recipient amniotic fluid metabolites, such as cardiac Troponin T and atrial natriuretic polypeptide, correlate with cardiac function in this fetus. The aim of this study is to describe the amniotic fluid metabolomic profile in TTTS, relate this to fetal recipient cardiac function and assess the metabolomic changes induced by fetoscopic laser coagulation...
August 2016: Placenta
Franca Grischott, Milo Puhan, Christoph Hatz, Patricia Schlagenhauf
BACKGROUND: Increasing numbers of confirmed cases of Zika virus (ZIKV) infection resulting from non-mosquito-borne transmission have been reported. METHODS: We performed a systematic literature review (PRISMA guidelines) on intrauterine, intrapartum, sexual and animal bite ZIKV transmission. The presence of the virus in breast milk, urine, saliva and blood transfusions was also reviewed. RESULTS: The search resulted in 285 papers of possible relevance, of which we included 53 in the systematic review...
July 2016: Travel Medicine and Infectious Disease
Kiranpreet Kaur, Mamta Bhardwaj, Prashant Kumar, Suresh Singhal, Tarandeep Singh, Sarla Hooda
Amniotic fluid embolism (AFE) is one of the catastrophic complications of pregnancy in which amniotic fluid, fetal cells, hair, or other debris enters into the maternal pulmonary circulation, causing cardiovascular collapse. Etiology largely remains unknown, but may occur in healthy women during labour, during cesarean section, after abnormal vaginal delivery, or during the second trimester of pregnancy. It may also occur up to 48 hours post-delivery. It can also occur during abortion, after abdominal trauma, and during amnio-infusion...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
Elaine L Duryea, Sarah K Happe, Donald D McIntire, Jodi S Dashe
OBJECTIVE: To evaluate the relationship between sonography surveillance interval and Quintero stage at diagnosis. METHODS: This was a retrospective cohort study of monochorionic diamniotic pregnancies diagnosed with TTTS and followed with serial sonography between 1997 and 2013. Women were divided into three cohorts: diagnosis at initial second-trimester sonogram, at a sonogram within 14 days of the prior exam, and at a sonogram greater than 14 days from the prior exam...
April 28, 2016: Journal of Maternal-fetal & Neonatal Medicine
Isabel Couck, Liesbeth Lewi
Twin-to-twin transfusion syndrome (TTTS) and twin anemia polycythemia sequence (TAPS) are complications unique to monochorionic twin pregnancies and their shared circulation. Both are the result of the transfusion imbalance in the intertwin circulation. TTTS is characterized by an amniotic fluid discordance, whereas in TAPS, there is a severe discordance in hemoglobin levels. The article gives an overview of the typical features of TTTS and TAPS placentas.
June 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
Luis D Pacheco, George Saade, Gary D V Hankins, Steven L Clark
OBJECTIVE: We sought to provide evidence-based guidelines regarding the diagnosis and management of amniotic fluid embolism. STUDY DESIGN: A systematic literature review was performed using MEDLINE, PubMed, EMBASE, and the Cochrane Library. The search was restricted to English-language articles published from 1966 through March 2015. Priority was given to articles reporting original research, in particular randomized controlled trials, although review articles and commentaries were consulted...
August 2016: American Journal of Obstetrics and Gynecology
Ronald López-Cepero, Joseph Santoro, Alberto de la Vega
Feto-fetal transfusion syndrome is a pathological process unique to diamniotic monochorionic pregnancies. It is the consequence of an unbalanced fetal blood flow through communicating vessels within a shared placenta. When it occurs, a polyuric, hypervolemic recipient twin co-exists with a hypovolemic oliguric donor. The presence of polyhydramnios or oligohydramnios is considered a poor prognostic indicator, whereas normal amniotic fluid volumes indicate a lack of clinically significant twintwin transfusion...
March 2016: Puerto Rico Health Sciences Journal
Xueju Wang, Yuan Wei, Pengbo Yuan, Yangyu Zhao
OBJECTIVE: To evaluate the effect on maternal blood dilution of fetoscopic laser occlusion of chorioangiopagous vessels (FLOC) in treating twin to twin transfusion syndrome (TTTS). METHODS: The clinical data of 71 cases of TTTS who had FLOC in Peking University Third Hospital were reviewed. Fluid intake, blood pressure, heart rate, red blood cell count, hemoglobin and hematocrit in perioperative 24 hours were analyzed. RESULTS: (1) According to the Quintero staging, 9 cases were stage Ⅰ, 24 were stage Ⅱ, 28 were stage Ⅲ and 10 cases were stage Ⅳ...
January 2016: Zhonghua Fu Chan Ke za Zhi
Serkan Bodur, Ismet Gun, Ozkan Ozdamar, Mustafa Alparslan Babayigit
OBJECTIVE: Hemorrhage still continues to be reported as one of the leading causes of maternal mortality and morbidity. Intraoperative estimation of the blood loss seems to be complex and misleading as it is impaired by the amount of amniotic fluid and blood from the placenta. The present study was aimed to investigate the safety of intraoperative deciding on an uneventful cesarean section in a low risk patient population. MATERIAL AND METHODS: One hundred patients free from hemorrhage risks and experienced an uneventful elective cesarean section, were included to the study...
2015: International Journal of Clinical and Experimental Medicine
Bettina Paek, Melissa Dorn, Martin Walker
BACKGROUND: The diagnosis of twin-to-twin transfusion syndrome (TTTS) usually relies the presence of polyhydramnios in one sac with concomitant oligohydramnios in the other sac in a monochorionic diamniotic twin pregnancy. However, TTTS does not always show a linear progression and may present with cardiac compromise or critically abnormal Doppler velocimetry in either fetus before fluid measurements meet the typically used cutoff. OBJECTIVE: The aim of this study was to investigate the prevalence of atypical presentations of TTTS in a population undergoing laser fetoscopy...
July 2016: American Journal of Obstetrics and Gynecology
Satoshi Hayashi, Ai Anami, Keisuke Ishii, Mari S Oba, Yuichiro Takahashi, Masahiko Nakata, Jun Murotsuki, Takeshi Murakoshi, Haruhiko Sago
OBJECTIVES: This study aimed to assess the perinatal outcome in monochorionic diamniotic (MD) twin pregnancies complicated by amniotic fluid discordance (AFD) adjoining twin-twin transfusion syndrome (TTTS). METHODS: An observational study of 84 consecutive MD twin pregnancies complicated by AFD that resembled TTTS was conducted. AFD adjoining TTTS was defined by a maximal vertical pocket of amniotic fluid ≤3 cm in one twin and ≥7 cm in the other excluding TTTS...
February 2016: Prenatal Diagnosis
Nolan McDonnell, Marian Knight, Michael J Peek, David Ellwood, Caroline S E Homer, Claire McLintock, Geraldine Vaughan, Wendy Pollock, Zhuoyang Li, Nasrin Javid, Elizabeth Sullivan
BACKGROUND: Amniotic fluid embolism (AFE) is a major cause of direct maternal mortality in Australia and New Zealand. There has been no national population study of AFE in either country. The aim of this study was to estimate the incidence of amniotic fluid embolism in Australia and New Zealand and to describe risk factors, management, and perinatal outcomes. METHODS: A population-based descriptive study using the Australasian Maternity Outcomes Surveillance System (AMOSS) carried out in 263 eligible sites (>50 births per year) covering an estimated 96% of women giving birth in Australia and all 24 New Zealand maternity units (100% of women giving birth in hospitals) between January 1 2010-December 31 2011...
2015: BMC Pregnancy and Childbirth
Renee Anita Bøgeskov, Lone Fuhrmann, Niels Klarskov
Amniotic fluid embolism is a serious and devastating complication in obstetrics. Despite a low incidence of 1-6:100.000, it remains one of the leading causes of maternal death in developed countries. Several risk factors have been proposed, but studies are conflicting, and to date there are no ways to predict or prevent this condition. Despite early and aggressive treatment, mortality and risk of neurological impairment remain high. We present a classic case of amniotic fluid embolism during labour and briefly discuss the current recommendations for treatment...
November 2, 2015: Ugeskrift for Laeger
Cande V Ananth, Jessica A Lavery, Anthony M Vintzileos, Daniel W Skupski, Michael Varner, George Saade, Joseph Biggio, Michelle A Williams, Ronald J Wapner, Jason D Wright
BACKGROUND: Placental abruption traditionally is defined as the premature separation of the implanted placenta before the delivery of the fetus. The existing clinical criteria of severity rely exclusively on fetal (fetal distress or fetal death) and maternal complications without consideration of neonatal or preterm delivery-related complications. However, two-thirds of abruption cases are accompanied by fetal or neonatal complications, including preterm delivery. A clinically meaningful classification for abruption therefore should include not only maternal complications but also adverse fetal and neonatal outcomes that include intrauterine growth restriction and preterm delivery...
February 2016: American Journal of Obstetrics and Gynecology
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