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Twin to twin transfusion syndrome

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https://www.readbyqxmd.com/read/29763608/early-prognostic-factors-of-outcomes-in-monochorionic-twin-pregnancy-systematic-review-and-meta-analysis
#1
REVIEW
Fiona L Mackie, Matthew J Hall, R Katie Morris, Mark D Kilby
OBJECTIVE: Assess ability of first trimester pregnancy related factors (ultrasound measurements, maternal characteristics, biomarkers) to predict complications in monochorionic twin pregnancies DATA SOURCES: MEDLINE, EMBASE, ISI Web of Science, CINAHL, the Cochrane Central Registration of Controlled Trials and Research Registers, and Google Scholar, from inception to 12 May 2017. Grey literature and bibliographies of articles were checked. STUDY ELIGIBILITY CRITERIA: Studies that reported ultrasound measurements, maternal characteristics, or potential biomarkers, measured in the first trimester in monochorionic diamniotic twin pregnancies, where the potential prognostic ability between the variable and twin-twin transfusion syndrome, growth restriction, or intrauterine fetal death could be assessed...
May 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29740835/factors-associated-to-early-intrauterine-fetal-demise-after-laser-for-ttts-by-pre-operative-fetal-heart-and-doppler-ultrasound
#2
Amélie Delabaere, France Leduc, Quentin Reboul, Florent Fuchs, Sandrine Wavrant, Johanne Dubé, Jean-Claude Fouron, François Audibert
OBJECTIVE: To determine the prognostic value of fetal Doppler and echocardiographic parameters for intra-uterine fetal demise (IUFD) within 24 hours and within one week after laser coagulation in monochorionic pregnancies complicated by twin-twin transfusion syndrome (TTTS). METHOD: This retrospective study correlated the preoperative hemodynamic and echocardiography parameters to the outcome in fetuses with TTTS undergoing laser therapy. RESULTS: One hundred and twelve laser coagulations were performed between February 2006 and June 2015...
May 9, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29704280/prediction-of-adverse-pregnancy-outcome-in-monochorionic-diamniotic-twin-pregnancies-complicated-by-selective-fetal-growth-restriction
#3
Caitriona Monaghan, Erkan Kalafat, Julia Binder, Baskaran Thilaganathan, Asma Khalil
OBJECTIVE: To identify key factors implicated in adverse perinatal outcome in monochorionic twin pregnancies complicated by selective fetal growth restriction. METHODS: This is a retrospective cohort study conducted in a single tertiary referral centre included all monochorionic diamniotic (MCDA) twin pregnancies complicated by selective fetal growth restriction (sFGR). The presence of co-existing twin to twin transfusion syndrome (TTTS) was noted. Fetal biometry and Doppler indices, including the umbilical artery (UA) and ductus venosus (DV), were recorded at the time of diagnosis...
April 28, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29698746/for-submission-to-the-journal-of-gynaecology-obstetrics-and-human-reproduction
#4
Mélanie Korsakissok, Marion Groussolles, Odile Dicky, Corinne Alberge, Charlotte Casper, Corinne Azogui-Assouline
OBJECTIVE: To describe the morbidity and mortality and long-term neurodevelopmental outcomes in children born from a Twin-to-Twin Transfusion Syndrome (TTTS) pregnancy treated using laser fetoscopy in Toulouse. POPULATION AND METHOD: All pregnancies with TTTS treated by laser fetoscopy in our centre were included. Antenatal and postnatal morbidity and neonatal morbidity were identified in the medical records retrospectively. The neurodevelopmental outcome was studied using Ages and Stages Questionnaires (ASQ) sent to the parents, an oral interview with the parents and with the child's doctor (last objective neurological examination, rehabilitation needs, learning disabilities)...
April 23, 2018: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/29688161/brain-injured-survivors-of-monochorionic-twin-pregnancies-complicated-by-single-intrauterine-death-mr-findings-in-a-multicenter-study
#5
Giorgio Conte, Andrea Righini, Paul D Griffiths, Mariangela Rustico, Mariano Lanna, Fiona L Mackie, Lorenzo Pinelli, Federico Prefumo, Nicola Persico, Mark S Igra, Cecilia Parazzini, Chiara Doneda, Anna Fichera, Claudia Ambrosi, Mark Kilby, Mariasavina Severino, Fabio Triulzi, Andrea Rossi, Nicholas Skipper
Purpose To describe and classify the range of brain injuries present at prenatal, in-utero magnetic resonance (MR) imaging in co-twin survivors of monochorionic (MC) twin pregnancies complicated by single intrauterine death (SIUD). Materials and Methods This retrospective, observational study from six tertiary fetal medicine centers that perform tertiary-level prenatal in-utero MR studies reviewed cases in which prenatal in-utero MR imaging had shown a brain injury in a surviving co-twin of a twin pregnancy with a MC component complicated by SIUD...
April 24, 2018: Radiology
https://www.readbyqxmd.com/read/29675904/risk-factors-for-fetal-death-after-radiofrequency-ablation-for-complicated-monochorionic-twin-pregnancies
#6
Luming Sun, Gang Zou, Yingjun Yang, Fenhe Zhou, Duan Tao
OBJECTIVE: Radiofrequency ablation (RFA) is a management alternative for complicated monochorionic twin pregnancies. The purpose of this study is to evaluate risk factors for fetal death after RFA. METHODS: An observational study was performed to document the perinatal outcomes of all cases undergoing fetal reduction using RFA from 2010 to 2016 at the Shanghai First Maternity and Infant Hospital. A multiple regression model was built to identify predictors of the death of the remaining fetus after RFA...
April 19, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29673002/incidence-of-and-risk-factors-for-severe-maternal-complications-associated-with-hypertensive-disorders-after-36-weeks-gestation-in-uncomplicated-twin-pregnancies-a-prospective-cohort-study
#7
Ryo Yamamoto, Keisuke Ishii, Haruka Muto, Shiyo Ota, Haruna Kawaguchi, Shusaku Hayashi, Nobuaki Mitsuda
AIM: To elucidate the incidence of and risk factors for severe hypertensive disorders (HD) and related maternal complications in uncomplicated twin pregnancies that reached 36 weeks' gestation. METHODS: We conducted a prospective cohort study of twin pregnancies delivered after 36 weeks' gestation. Cases of twin-twin transfusion syndrome, twin anemia-polycythemia sequence, malformed fetuses, monoamniotic twins, selective reduction, fetal therapy and HD or fetal death before 35 weeks' gestation were excluded...
April 19, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29630059/model-surgical-training-skills-acquisition-in-fetoscopic-laser-photocoagulation-of-monochorionic-diamniotic-twin-placenta-using-realistic-simulators
#8
Tuangsit Wataganara, Arundhati Gosavi, Katika Nawapun, Pradip D Vijayakumar, Nisarat Phithakwatchara, Mahesh Choolani, Lin Lin Su, Arijit Biswas, Citra N Z Mattar
Fetoscopic laser coagulation of arterio-venous anastomoses (AVA) in a monochorionic placenta is the standard of care for twin-twin transfusion syndrome (TTTS), but is technically challenging and can lead to significant complications. Acquiring and maintaining the necessary surgical skills require consistent practice, a critical caseload, and time. Training on realistic surgical simulators can potentially shorten this steep learning curve and enables several proceduralists to acquire procedure-specific skills simultaneously...
March 21, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29607558/outcome-reporting-across-randomised-trials-and-observational-studies-evaluating-treatments-for-twin-twin-transfusion-syndrome-a-systematic-review
#9
REVIEW
Helen Perry, James M N Duffy, Ogochukwu Umadia, Asma Khalil
BACKGROUND: Twin-Twin Transfusion syndrome is associated with significant mortality and morbidity. Potential treatments require robust evaluation. The aim of this study was to evaluate outcome reporting across observational studies and randomised controlled trials assessing treatments for twin-twin transfusion syndrome (TTTS). METHODS: Cochrane Central Register of Controlled Trials, EMBASE and Medline were searched from inception to August 2016. Observational studies and randomised controlled trials reporting outcomes following a treatment for TTTS in monochorionic-diamniotic twin pregnancies and monochorionic-triamniotic or dichorionic-triamniotic triplet pregnancies were included...
April 1, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29592974/sodium-nitroprusside-a-lifesaving-treatment-for-neonatal-hypertension-an-irish-experience
#10
Alina Gina Deliu, Phani Bhushan Jeerigehalli Sanneerappa, Orla Franklin, Johannes Letshwiti
We present a 30+2-weeks-old (30 weeks and 2 days) male, twin 1, born by emergency caesarean section due to twin-twin transfusion syndrome (absent end-diastolic flow and cardiac anomaly in twin 2) presenting with hypertensive crisis on day 3. He was already on milrinone and propranolol. His echocardiogram showed poor left ventricular contractility and after cardiology consultation received sodium nitroprusside, which eventually saved his life by decreasing his blood pressure and improving cardiac function. As sodium nitroprusside is very rarely used for hypertensive crisis in neonates, we would like to share our experiences on dosage, challenges in administration due to its fast onset of action, criteria for monitoring for complications and finally weaning...
March 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29582948/-advances-in-fetal-therapy-in-complicated-monochorionic-pregnancies-and-in-severe-congenital-diaphragmatic-hernia-five-years-experience
#11
Yuval Gielchinsky, Dan V Valsky, Nili Yanai, Firas J Abdeljawad, Mazen A Muhaisen, Dan Arbell, Yehuda Ginosar, Orna Ben-Yosef, Orite Winograd, Benjamin Bar-Oz, Simcha Yagel, Smadar Eventov-Friedman
INTRODUCTION: : Minimally invasive fetal therapeutic procedures reduce the morbidity and mortality in monochorionic (MC) twins and in fetuses with congenital diaphragmatic hernia (CDH). MC pregnancies share their blood systems due to communicating vessels over their single placenta and may develop specific complications: Twin-to-Twin transfusion syndrome (TTTS), Selective intrauterine growth restriction (sIUGR), Twin Anemia-Polycythemia Sequence (TAPS), Twin Reverse Arterial Perfusion Syndrome (TRAP) or anomalies in one...
March 2018: Harefuah
https://www.readbyqxmd.com/read/29573746/effects-of-inter-twin-vascular-anastomoses-of-monochorionic-twins-with-selective-intrauterine-growth-restriction-on-the-contents-of-placental-mitochondria-dna
#12
Yao-Lung Chang, An-Shine Chao, Hsiu-Huei Peng, Shuenn-Dyh Chang, Sheng-Yuan Su, Kuan-Ju Chen, Tzu-Hao Wang
BACKGROUND: Placental mitochondrial DNA (mtDNA) has been proposed to be an indicator for placental hypoxia. This study was designed to evaluate the effect of vascular anastomoses between monochorionic (MC) twins on placental mtDNA. METHODS: In this study, twin-twin transfusion syndrome (TTTS) treated with laser therapy and MC twins without TTTS (without laser therapy) resulting in two live babies were included in this study. The placental mtDNA fold changes (FC) between the small and large twins were analyzed using real-time quantitative PCR...
March 24, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29558751/sudden-fetal-hematologic-changes-as-a-complication-of-amnioreduction-in-twin-twin-transfusion-syndrome
#13
Katarzyna Kosinska-Kaczynska, Michal Lipa, Iwona Szymusik, Dorota Bomba-Opon, Robert Brawura-Biskupski-Samaha, Szymon Kozlowski, Lisanne S A Tollenaar, Dick Oepkes, Miroslaw Wielgos, Enrico Lopriore
We present the first case of a monochorionic twin pregnancy in which sudden hematologic changes occurred as a complication of the amnioreduction procedure for twin-twin transfusion syndrome (TTTS). At 33 weeks of gestation, 4 days after the amnioreduction, the recipient developed severe anemia while the donor developed severe polycythemia. Postnatal placental examination revealed several arteriovenous and venoarterial anastomoses, a pale placental mass of the recipient and a congested and plethoric placental mass of the donor...
March 20, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29553462/harmony-behind-the-trumped-shaped-vessel-the-essential-role-of-the-ductus-venosus-in-fetal-medicine
#14
Sifa Turan, Ozhan M Turan
The ductus venosus is a fetal vessel that functions importantly in the transfer of oxygen-and nutrient-rich blood from the umbilical vein to vital organs. Its control under active regulation and its anatomy result in a flow-velocity profile that is typically forward throughout the cardiac cycle. This forward cardiac function reflects afterload, cardiac contractility, compliance, and vascular volume changes. Ductus venosus assessment gives valuable information under different fetal conditions. For example, during first trimester screening, an abnormal ductus venosus measurement changes the screening result...
March 15, 2018: Balkan Medical Journal
https://www.readbyqxmd.com/read/29546573/retrieval-and-registration-of-long-range-overlapping-frames-for-scalable-mosaicking-of-in-vivo-fetoscopy
#15
Loïc Peter, Marcel Tella-Amo, Dzhoshkun Ismail Shakir, George Attilakos, Ruwan Wimalasundera, Jan Deprest, Sébastien Ourselin, Tom Vercauteren
PURPOSE: The standard clinical treatment of Twin-to-Twin transfusion syndrome consists in the photo-coagulation of undesired anastomoses located on the placenta which are responsible to a blood transfer between the two twins. While being the standard of care procedure, fetoscopy suffers from a limited field-of-view of the placenta resulting in missed anastomoses. To facilitate the task of the clinician, building a global map of the placenta providing a larger overview of the vascular network is highly desired...
May 2018: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29533957/in-utero-partial-exchange-transfusion-combined-with-in-utero-blood-transfusion-for-prenatal-management-of-twin-anemia-polycythemia-sequence
#16
Mert Ozan Bahtiyar, Emre Ekmekci, Emine Demirel, Roxanna A Irani, Joshua A Copel
Monochorionic twin pregnancies are at risk of unique complications due to placental sharing and vascular connections between placental territories assigned for each twin. Twin anemia-polycythemia sequence (TAPS) is an infrequent but potentially dangerous complication of abnormal placental vascular connections. TAPS occurs due to very-small-caliber (< 1 mm) abnormal placental vascular connections which lead to chronic anemia in the donor twin and polycythemia in the recipient twin. TAPS may occur spontaneously or following fetoscopic laser photocoagulation of communicating placental vessels for twin-twin transfusion syndrome...
March 13, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29528469/stage-i-twin-twin-transfusion-syndrome-outcomes-of-expectant-management-and-prognostic-features
#17
Erin E Washburn, Teresa N Sparks, Kristen A Gosnell, Larry Rand, Juan M Gonzalez, Vickie A Feldstein
OBJECTIVE:  This article describes the natural history of stage I twin-twin transfusion syndrome (TTTS) including risk of progression to higher stage TTTS and pregnancy outcomes, and to identify risk factors for progression. STUDY DESIGN:  Retrospective cohort study of monochorionic diamniotic (MCDA) twin pregnancies from 2006 to 2016 with expectantly managed Quintero stage I TTTS. RESULTS:  A total of 30 MCDA twin pregnancies with expectantly managed stage I TTTS were identified...
February 8, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29487889/probabilistic-visual-and-electromagnetic-data-fusion-for-robust-drift-free-sequential-mosaicking-application-to-fetoscopy
#18
Marcel Tella-Amo, Loic Peter, Dzhoshkun I Shakir, Jan Deprest, Danail Stoyanov, Juan Eugenio Iglesias, Tom Vercauteren, Sebastien Ourselin
The most effective treatment for twin-to-twin transfusion syndrome is laser photocoagulation of the shared vascular anastomoses in the placenta. Vascular connections are extremely challenging to locate due to their caliber and the reduced field-of-view of the fetoscope. Therefore, mosaicking techniques are beneficial to expand the scene, facilitate navigation, and allow vessel photocoagulation decision-making. Local vision-based mosaicking algorithms inherently drift over time due to the use of pairwise transformations...
April 2018: Journal of Medical Imaging
https://www.readbyqxmd.com/read/29467101/ultrasound-screening-for-complications-in-twin-pregnancy
#19
Rosemary Townsend, Asma Khalil
In the decades since the introduction of ultrasound into routine obstetric practice, the advantages of ultrasound have moved beyond the simple ability to identify multiple pregnancies antenatally to the possibility of screening them for fetal anomalies, pre-eclampsia, preterm birth, and the complications specific to monochorionic pregnancies. Screening studies have often excluded twins because physiological differences impact on the validity and sensitivity of the screening tests in routine use in singletons, and therefore, the evidence of screening performance in multiple pregnancy lags behind the evidence from singleton pregnancies...
April 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29436718/fetal-doppler-changes-1-week-after-endoscopic-equatorial-laser-for-twin-to-twin-transfusion-syndrome-a-longitudinal-study
#20
Nicola Persico, Francesco D'Ambrosi, Isabella Fabietti, Simona Boito, Elisa Aiello, Alessandro Bulfoni, Fabrizio Ciralli, Alessandra Kustermann, Fabio Mosca, Luigi Fedele
OBJECTIVE: To investigate sequential Doppler changes in donors and recipients before and 1 week after endoscopic laser for twin-to-twin transfusion syndrome (TTTS) and to examine factors that may be associated with such changes. METHODS: In TTTS pregnancies undergoing laser treatment, we examined fetal Doppler changes before and 1 week postintervention. Intrauterine death rates and preoperative factors were analyzed in relation to Doppler changes. RESULTS: Among 129 (85...
April 2018: Prenatal Diagnosis
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