790 results match your criteria Twin-to-Twin Transfusion Syndrome


A core outcome set for the evaluation of treatments for twin-twin transfusion syndrome.

Ultrasound Obstet Gynecol 2018 Dec 6. Epub 2018 Dec 6.

Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London SW17 0RE, United Kingdom.

Background: A minimum data set, known as a core outcome set, should standardise outcome selection, collection, and reporting across future twin-to-twin transfusion syndrome research.

Methods: An international steering group including healthcare professionals, researchers, and patients, guided the development of this core outcome set. Potential core outcomes, identified through a comprehensive literature review, were entered into a three round Delphi survey. Read More

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December 2018
1 Read

A Comparison of Spinal Anesthesia Versus Monitored Anesthesia Care With Local Anesthesia in Minimally Invasive Fetal Surgery.

Anesth Analg 2018 Nov 21. Epub 2018 Nov 21.

Department of Anesthesiology, University of Utah, Salt Lake City, Utah.

Background: Minimally invasive fetal surgery is commonly performed to treat twin-to-twin transfusion syndrome with selective fetoscopic laser photocoagulation and twin-reversed arterial perfusion sequence using radiofrequency ablation. Although an increasing number of centers worldwide are performing these procedures, anesthetic management varies. Both neuraxial anesthesia and monitored anesthesia care with local anesthesia are used at different institutions. Read More

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November 2018

Deep-learned placental vessel segmentation for intraoperative video enhancement in fetoscopic surgery.

Int J Comput Assist Radiol Surg 2018 Nov 27. Epub 2018 Nov 27.

Yale University School of Medicine, New Haven, USA.

Introduction: Twin-to-twin transfusion syndrome (TTTS) is a potentially lethal condition that affects pregnancies in which twins share a single placenta. The definitive treatment for TTTS is fetoscopic laser photocoagulation, a procedure in which placental blood vessels are selectively cauterized. Challenges in this procedure include difficulty in quickly identifying placental blood vessels due to the many artifacts in the endoscopic video that the surgeon uses for navigation. Read More

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November 2018

Ultrasound surveillance in twin pregnancy: An update for practitioners.

Authors:
R Townsend A Khalil

Ultrasound 2018 Nov 22;26(4):193-205. Epub 2018 Aug 22.

Fetal Medicine Unit, St. George's University of London, London, UK.

Ultrasound has revolutionised the management of multiple pregnancies and their complications. Increasing frequency of twin pregnancies mandates familiarity of all clinicians with the relevant pathologies and evidence-based surveillance and management protocols for their care. In this review, we summarise the latest evidence relating to ultrasound surveillance of twin pregnancies including first trimester assessment and screening, growth surveillance and the detection and management of the complications of monochorionic pregnancies including twin-to-twin-transfusion syndrome, selective fetal growth restriction, twin reversed arterial perfusion sequence and conjoined twinning. Read More

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November 2018
4 Reads

Outcomes of monoamniotic twin pregnancies managed primarily in outpatient care-A Danish multicenter study.

Acta Obstet Gynecol Scand 2018 Nov 25. Epub 2018 Nov 25.

Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.

Introduction: Monoamniotic twin pregnancies are high-risk pregnancies, and management by inpatient or frequent outpatient care is recommended. We report the outcomes of a national cohort of monoamniotic twin pregnancies managed primarily as outpatients MATERIAL AND METHODS: We analyzed prospectively recorded data from the Danish Fetal Medicine Database, local databases, and medical records of all monoamniotic twin pregnancies diagnosed at the first trimester scan or later, and managed at the six major fetal medicine centers in Denmark over a 10 year period RESULTS: Sixty-one monoamniotic twin pregnancies were included. Thirteen pregnancies were terminated early. Read More

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November 2018
3 Reads

Role of velamentous cord insertion in monochorionic twin pregnancies: a PRISMA-compliant systematic review and meta-analysis of observational studies.

J Matern Fetal Neonatal Med 2018 Nov 20:1-261. Epub 2018 Nov 20.

a Foshan Institute of Fetal Medicine , Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan , Foshan , China.

Background: Velamentous cord insertion (VCI) has been proposed to be associated with some specific complications among monochorionic (MC) twin pregnancies. This meta-analysis and systematic review aims to determine the role of VCI in MC twin pregnancies.

Methods: The PubMed, Embase and Web of Science databases and reference lists were searched for relevant studies. Read More

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November 2018
4 Reads

Fetal Surgery and Delayed Cord Clamping: Neonatal Implications.

Authors:
Karen M Frank

Crit Care Nurs Clin North Am 2018 Dec 16;30(4):499-507. Epub 2018 Oct 16.

Department of Nursing, Towson University, LI 322, 8000 York Road, Towson, MD 21252, USA. Electronic address:

Advances made in the last several decades in the care of the fetus and newborn have had a significant impact on morbidity and mortality. Delayed umbilical cord clamping in the preterm newborn results in fewer transfusions for anemia, decreased intraventricular hemorrhage, and decreased necrotizing enterocolitis. Because of advances made in fetal ultrasound diagnosis and technological advances, fetal surgeries to treat congenital diaphragmatic hernia, myelomeningocele, twin-to-twin transfusion syndrome, fetal lower urinary tract obstructions, amniotic band syndrome, and congenital cystic adenoid malformation or congenital pulmonary airway malformations have improved the quality of life and survival for these patients. Read More

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December 2018
2 Reads

Short-term outcome of the second twin during vaginal delivery is dependent on delivery time interval but not chorionicity.

J Obstet Gynaecol 2018 Nov 10:1-5. Epub 2018 Nov 10.

a Department of Obstetrics and Gynecology , Karolinska University Hospital , Stockholm , Sweden.

The decrease in pH in monochorionic (MC) second twin may exceed that of dichorionic (DC) second twin during vaginal twin delivery. The aim of this study was to investigate the effect of chorionicity on the umbilical artery pH of the second twin in relation to increased twin-to-twin delivery time interval (DTI) from 30 weeks of gestation. A hospital based cohort of all twin deliveries after 30 completed weeks of gestation with the first twin delivered vaginally between 2007 and 2012 in four delivery units in Stockholm county was conducted. Read More

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November 2018
2 Reads

The effects of birth order on neonatal outcomes in early-preterm, late-preterm and term twin infants.

J Matern Fetal Neonatal Med 2018 Nov 4:1-8. Epub 2018 Nov 4.

a Department of Obstetrics and Gynecology , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea.

Objectives: Birth order is one of the main factors that influences the neonatal outcome of twins. However, there is little prior data regarding the effect of birth order under different clinical circumstances. This study investigates the effect of birth order on the neonatal outcomes of twins delivered during early-preterm, late-preterm and term gestations according to chorionicity, delivery mode and indication for delivery. Read More

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November 2018
3 Reads

Segmentation and classification in MRI and US fetal imaging: Recent trends and future prospects.

Med Image Anal 2019 Jan 19;51:61-88. Epub 2018 Oct 19.

BCN MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain; ICREA, Barcelona, Spain.

Fetal imaging is a burgeoning topic. New advancements in both magnetic resonance imaging and (3D) ultrasound currently allow doctors to diagnose fetal structural abnormalities such as those involved in twin-to-twin transfusion syndrome, gestational diabetes mellitus, pulmonary sequestration and hypoplasia, congenital heart disease, diaphragmatic hernia, ventriculomegaly, etc. Considering the continued breakthroughs in utero image analysis and (3D) reconstruction models, it is now possible to gain more insight into the ongoing development of the fetus. Read More

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January 2019
5 Reads

Major Discordant Structural Anomalies in Monochorionic Twins: Spectrum and Outcomes.

Twin Res Hum Genet 2018 Oct 30:1-10. Epub 2018 Oct 30.

Department of Obstetrics and Gynecology,Vittore Buzzi Children's Hospital,Università di Milano,Milan,Italy.

Monochorionic twins, resulting from a single fertilized egg giving rise to two separate embryos, are monozygotic and considered genetically identical. However, discordant phenotypes have been reported in monozygotic twins. We analyzed a retrospective cohort of 155 monochorionic pregnancies (312 twins) with major discordant structural anomalies coded by the ICD-10 system in order to describe the spectrum of anomalies, the management of the pregnancies, and the perinatal outcome. Read More

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October 2018
1 Read

Acquired right ventricular outflow tract obstruction in twin-to-twin transfusion syndrome; a prospective longitudinal study.

Prenat Diagn 2018 Oct 26. Epub 2018 Oct 26.

Department of Obstetrics, Division of Fetal Medicine, Leiden University Medical Center, Leiden, Netherlands.

Objective: The pathophysiology of right ventricular outflow tract obstruction (RVOTO) in twin-to-twin transfusion syndrome (TTTS) recipients is incompletely understood. We aimed to investigate the development and spectrum of RVOTO in TTTS recipients.

Methods: A prospective longitudinal cohort study was conducted between 2015 and 2017. Read More

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October 2018
7 Reads

Beta blocker therapy in recipients of twin-to-twin transfusion syndrome.

Arch Dis Child Fetal Neonatal Ed 2018 Oct 24. Epub 2018 Oct 24.

Department of Neonatology, Children's University Hospital, Tuebingen, Germany.

Recipients of severe twin-to-twin transfusion syndrome (TTTS) may suffer from low cardiac output caused by myocardial hypertrophy and sudden postnatal drop in preload. Our hypothesis was that selective beta-1 adrenergic blockers improve cardiac function in TTTS recipients with left ventricular outflow tract obstruction. We analysed data from two TTTS recipients treated with esmolol/metoprolol. Read More

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October 2018
1 Read

Measurement of cardiac function by cardiac time intervals, applicability in normal pregnancy and twin-to-twin transfusion syndrome.

J Echocardiogr 2018 Oct 20. Epub 2018 Oct 20.

Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, B3-089, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.

Background: To detect early cardiac deterioration, a simple and stable tool is needed. Measurement of time intervals in a simple 4-chamber view using color-coded tissue Doppler imaging is a relatively new approach to assess fetal cardiac function. The aim of this study was to evaluate the applicability of this modality and to construct reference ranges for cardiac time intervals. Read More

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October 2018
5 Reads

Bisphosphonate therapy in an infant with generalized arterial calcification with an ABCC6 mutation.

Osteoporos Int 2018 Sep 11. Epub 2018 Sep 11.

Center For Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.

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. Read More

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September 2018
1 Read

Outcome after fetoscopic laser coagulation in twin-twin transfusion syndrome - is the survival rate of at least one child at 6 months of age dependent on preoperative cervical length and preterm prelabour rupture of fetal membranes?

J Matern Fetal Neonatal Med 2018 Sep 10:1-9. Epub 2018 Sep 10.

a Department of Obstetrics , University Hospital Zurich , Zurich , Switzerland.

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. Read More

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September 2018
1 Read

Twin Reversed Arterial Perfusion Sequence: Assessing the Role of the Correct Imaging Modality in a Rare Clinical Entity.

Cureus 2018 Jul 2;10(7):e2910. Epub 2018 Jul 2.

Department of Pathology, Aga Khan University Hospital, Karachi, PAK.

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). Read More

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July 2018
7 Reads

Long-term outcomes for monochorionic twins after laser therapy in twin-to-twin transfusion syndrome.

Lancet Child Adolesc Health 2018 Jul 30;2(7):525-535. Epub 2018 May 30.

Children's Hospital, University Hospital Bonn, Bonn, Germany.

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. Read More

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July 2018
10 Reads

[Bicolour placenta: An illustration of the twin to twin transfusion syndrome].

Ann Pathol 2018 Dec 16;38(6):407. Epub 2018 Aug 16.

Service d'anatomie et cytologie pathologiques, CHU de Grenoble-Alpes, CS10217, avenue Maquis-du-Grésivaudan, 38043 Grenoble cedex 9, France.

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December 2018
6 Reads

Addressing the variation in outcome reporting in high risk twin studies: The key to reducing research waste and improving clinical care.

Ultrasound Obstet Gynecol 2018 Aug 6. Epub 2018 Aug 6.

Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St. George's University Hospitals NHS Foundation Trust, Blackshaw Road, London, United Kingdom.

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. Read More

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August 2018
7 Reads

Twin-to-twin transfusion syndrome neurodevelopmental follow-up study (neurodevelopmental outcomes for children whose twin-to-twin transfusion syndrome was treated with placental laser photocoagulation).

BMC Pediatr 2018 Aug 1;18(1):256. Epub 2018 Aug 1.

Department of Obstetrics and Gynaecology, Mercy Hospital for Women, Heidelberg, Australia.

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. Read More

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August 2018
11 Reads

Fetoscopic laser photocoagulation for twin-to-twin transfusion syndrome treatment: initial experience in tertiary reference center in Brazil.

Obstet Gynecol Sci 2018 Jul 20;61(4):461-467. Epub 2018 Jun 20.

Department of Obstetrics, Paulista School of Medicine, São Paulo Federal University (EPM-UNIFESP), São Paulo, SP, Brazil.

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. Read More

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July 2018
2 Reads

Twin-to-twin-transfusion syndrome: from amniodrainage to laser.

BJOG 2018 Aug;125(9):1163

Faculty of Population Health Sciences, EGA Institute for Women's Health, University College London, UK.

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Near to One's Heart: The Intimate Relationship Between the Placenta and Fetal Heart.

Front Physiol 2018 26;9:629. Epub 2018 Jun 26.

Department of Physiology, Development and Neuroscience and Centre for Trophoblast Research, University of Cambridge, Cambridge, United Kingdom.

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. Read More

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June 2018
6 Reads

Towards computer-assisted TTTS: Laser ablation detection for workflow segmentation from fetoscopic video.

Int J Comput Assist Radiol Surg 2018 Oct 27;13(10):1661-1670. Epub 2018 Jun 27.

Wellcome / EPSRC Centre for Interventional and Surgical Sciences Centre For Medical Image Computing, University College London, London, UK.

Purpose: Intrauterine foetal surgery is the treatment option for several congenital malformations. For twin-to-twin transfusion syndrome (TTTS), interventions involve the use of laser fibre to ablate vessels in a shared placenta. The procedure presents a number of challenges for the surgeon, and computer-assisted technologies can potentially be a significant support. Read More

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October 2018
10 Reads

When Is It Appropriate to Put a Live Donor at Risk to Help Another Patient?

Authors:
Anjay Khandelwal

AMA J Ethics 2018 Jun 1;20(1):537-545. Epub 2018 Jun 1.

The director of the Comprehensive Burn Care Center and the co-director of the Institute of Burn Ethics at MetroHealth Medical Center in Cleveland, Ohio, and an assistant professor of surgery and bioethics at the Case Western Reserve University School of Medicine.

This article considers the nature and scope of ethical decision making in monozygotic sibling (MZS) skin grafting. Although rare, identical twin-to-twin skin grafting has been reported with excellent survival rates in burn patients. Of 16 cases published to date, only a few address the ethical decision making process that is involved with monozygotic sibling skin grafting; this article discusses clinical indications and ethical challenges. Read More

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A case of mirror syndrome caused by hydrops fetalis after fetoscopic laser photocoagulation.

Clin Case Rep 2018 Jun 6;6(6):1010-1013. Epub 2018 Apr 6.

Department of Obstetrics and Gynecology Faculty of Medicine University of Miyazaki Miyazaki Japan.

Fetoscopic laser photocoagulation (FLP) of placental anastomoses is a well-established procedure for twin-to-twin transfusion syndrome that improves fetal outcome with rare maternal complications. However, fetal hydrops can develop even after FLP, and mirror syndrome can occur, indicating that both the fetal and maternal courses should be monitored after FLP. Read More

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June 2018
3 Reads

Differences in the Expression of TLR-2, NOD2, and NF-κB in Placenta Between Twins.

Arch Immunol Ther Exp (Warsz) 2018 Dec 23;66(6):463-470. Epub 2018 May 23.

Chair and Department of Oncologic Pathology and Prophylactics, Greater Poland Cancer Center, Poznań University of Medical Sciences and Department of Oncologic Pathology, Poznan, Poland.

Dizygotic twins share the same type of genetic relationship as non-twin siblings. Whereas monozygotic (MZ) twins are considered to have identical genetic material, they still differ. There is a number of reasons for early MZ twin discordance, including differences in the in utero environment, stochasticity, genetic mosaicism, and epigenetic factors. Read More

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December 2018
5 Reads
3.180 Impact Factor

Cancer cell transmission via the placenta.

Evol Med Public Health 2018 14;2018(1):106-115. Epub 2018 Apr 14.

School of Life Sciences, University of Sussex, Brighton BN1 9QG, UK.

Cancer cells have a parasitic propensity in the primary host but their capacity to transit between individuals is severely restrained by two factors: a lack of a route for viable cell transfer and immune recognition in allogeneic, secondary recipients. Several examples of transmissible animal cancers are now recognised. In humans, the only natural route for transmission is via the haemochorial placenta which is permissive for cell traffic. Read More

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Investigating the Epigenetic Discrimination of Identical Twins Using Buccal Swabs, Saliva, and Cigarette Butts in the Forensic Setting.

Genes (Basel) 2018 May 14;9(5). Epub 2018 May 14.

Department of Genetic Identification, Erasmus MC University Medical Center Rotterdam, 3015 CN Rotterdam, The Netherlands.

Monozygotic (MZ) twins are typically indistinguishable via forensic DNA profiling. Recently, we demonstrated that epigenetic differentiation of MZ twins is feasible; however, proportions of twin differentially methylated CpG sites (tDMSs) identified in reference-type blood DNA were not replicated in trace-type blood DNA. Here we investigated buccal swabs as typical forensic reference material, and saliva and cigarette butts as commonly encountered forensic trace materials. Read More

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May 2018
3 Reads

Prediction of adverse pregnancy outcome in monochorionic- diamniotic twin pregnancies complicated by selective fetal growth restriction.

Ultrasound Obstet Gynecol 2018 Apr 28. Epub 2018 Apr 28.

Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK.

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. Read More

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April 2018
7 Reads

Mortality, morbidity and 2-years neurodevelopmental prognosis of twin to twin transfusion syndrome after fetoscopic laser therapy: a prospective, 58 patients cohort study.

J Gynecol Obstet Hum Reprod 2018 Dec 23;47(10):555-560. Epub 2018 Apr 23.

Department of Neonatology, Children Hospital, University Hospital, 31000 Toulouse, France.

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. Read More

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December 2018
11 Reads

[ADVANCES IN FETAL THERAPY IN COMPLICATED MONOCHORIONIC PREGNANCIES AND IN SEVERE CONGENITAL DIAPHRAGMATIC HERNIA: FIVE YEARS EXPERIENCE].

Harefuah 2018 Mar;157(3):170-174

Department of Neonatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

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. Half of complicated MC require intrauterine interventions. Read More

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March 2018
8 Reads

Harmony Behind the Trumped-Shaped Vessel: the Essential Role of the Ductus Venosus in Fetal Medicine.

Balkan Med J 2018 03;35(2):124-130

Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland, Baltimore, USA.

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. Read More

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Retrieval and registration of long-range overlapping frames for scalable mosaicking of in vivo fetoscopy.

Int J Comput Assist Radiol Surg 2018 May 15;13(5):713-720. Epub 2018 Mar 15.

Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK.

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. Read More

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May 2018
5 Reads

A Possible Twin: The 1960s Twin Study Revisited/Twin Research: Twin-to-Twin Heart Transplantation; Distinguishing Monozygotic Twins; Twin Conceptions via Oocyte Donation; Factors Affecting Craniofacial Traits/In the Media: Triplet Delivery in the UK; Conjoined Twins and the Concept of Self; Colombian Twin Trainers; Skin Grafting to Save an Identical Co-Twin; Lack of Physical Flaws in Dolly the Cloned Sheep; Possible Conjoined Twins of Opposite-Sex; Passing of the Remaining Twin From the World's Longest Separated Pair.

Authors:
Nancy L Segal

Twin Res Hum Genet 2018 04 15;21(2):155-162. Epub 2018 Mar 15.

Department of Psychology,California State University,Fullerton,CA,USA.

This article begins with the story of a 51-year-old Los Angeles, California man, Justin Goldberg, whose daughter caught a glimpse of his striking look-alike at a popular market. Many people have so-called doppelgängers, but this occurrence is especially intriguing - the individual in question, born in New York City in the mid-1960s to an unwed mother, was an adoptee placed by the Louise Wise Adoption Agency. This agency, under the guidance of a prominent psychiatrist, decided to place twins in separate homes. Read More

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Role of ultrasonography in the management of twin gestation.

Int J Gynaecol Obstet 2018 Jun 2;141(3):304-314. Epub 2018 Apr 2.

Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA.

Twins represent 1%-2% of all pregnancies, yet continue to account for a disproportionate share of neonatal adverse events including neonatal intensive care admission, morbidity, and mortality. Ultrasonography is central to the proper diagnosis of the type of twinning. Ideally, ultrasonography is performed before 14 weeks of gestation to determine chorionicity and amnionicity. Read More

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June 2018
3 Reads

Probabilistic visual and electromagnetic data fusion for robust drift-free sequential mosaicking: application to fetoscopy.

J Med Imaging (Bellingham) 2018 Apr 22;5(2):021217. Epub 2018 Feb 22.

University College London, Wellcome/EPSRC Center for Interventional and Surgical Sciences, London, United Kingdom.

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. Read More

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April 2018
4 Reads

Fetal Doppler changes 1 week after endoscopic equatorial laser for twin-to-twin transfusion syndrome: A longitudinal study.

Prenat Diagn 2018 04 26;38(5):344-348. Epub 2018 Feb 26.

Department of Obstetrics and Gynecology 'L. Mangiagalli', Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.

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. Read More

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April 2018
7 Reads

Impact of laser therapy for twin-to-twin transfusion syndrome on subsequent pregnancy.

Prenat Diagn 2018 03 19;38(4):293-297. Epub 2018 Feb 19.

Department of Obstetrics and Fetal Therapy, AP-HP, Necker-Enfants Malades Hospital, Paris, France.

Objectives: The objective of our study was to determine the impact of laser therapy for twin-to-twin transfusion syndrome (TTTs) on subsequent pregnancies.

Methods: This was a monocentric retrospective observational study. Women treated by laser fetoscopy for TTTs were asked to answer a postal questionnaire about subsequent pregnancies. Read More

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March 2018
7 Reads

Late-onset transient adrenal insufficiency in preterm twins with twin-to-twin transfusion syndrome: A case report.

Medicine (Baltimore) 2017 Nov;96(47):e8686

Department of Pediatrics, E-Da Hospita.

Rationale: Late-onset transient adrenal insufficiency with circulatory collapse is a rare condition that occurs in preterm infants. Although the incidence of late-onset transient adrenal insufficiency in preterm infants has been reported in Japan, reports from Western countries are lacking. In addition, no study has investigated the effect of twin-to-twin transfusion syndrome (TTTS) in monozygotic twins. Read More

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November 2017

Differential Changes in Myocardial Performance Index and Its Time Intervals in Donors and Recipients of Twin-to-Twin Transfusion Syndrome before and after Laser Therapy.

Fetal Diagn Ther 2018 19;44(4):305-310. Epub 2018 Jan 19.

BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.

Objective: To evaluate left myocardial performance index (MPI) and time intervals in fetuses with twin-to-twin transfusion syndrome (TTTS) before and after laser surgery.

Methods: Fifty-one fetal pairs with TTTS and 47 uncomplicated monochorionic twin pairs were included. Left ventricular isovolumetric contraction time (ICT), ejection time (ET), and isovolumetric relaxation time (IRT) were measured using conventional Doppler. Read More

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January 2018
11 Reads

The effect of twin-to-twin delivery time intervals on neonatal outcome for second twins.

BMC Pregnancy Childbirth 2018 01 19;18(1):36. Epub 2018 Jan 19.

Department of Obstetrics and Gynecology, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, Diagnosvägen 15, 416 85, Gothenburg, Sweden.

Background: The objective was to examine the effect of twin-to-twin delivery intervals on neonatal outcome for second twins.

Methods: This was a retrospective, hospital-based study, performed at a university teaching hospital in Western Sweden. Twin deliveries between 2008 and 2014 at ≥32 + 0 weeks of gestation, where the first twin was delivered vaginally, were included. Read More

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January 2018
3 Reads

Redness discordance in monochorionic twin placentas: Correlation with clinical and placental findings.

Placenta 2017 Dec 26;60:54-60. Epub 2017 Oct 26.

Department of Pathology, Women and Infants Hospital, Providence, RI, 02905, United States.

Introduction/objectives: Recent studies suggest redness (color) discordance of the placental basal plate may be a marker for twin anemia-polycythemia sequence (TAPS), a recently described complication of diamniotic-monochorionic twinning characterized by marked intertwin hemoglobin (Hb) discordance in the absence of oligohydramnios-polyhydramnios. In this study, we determined the clinicoplacental and choriovascular correlates of basal plate color discordance in monochorionic twin placentas, and assessed its value as postnatal indicator of TAPS.

Methods: We performed a clinicoplacental analysis of 100 consecutive non-TTTS diamniotic-monochorionic twin placentas with available photographic documentation of the basal plate. Read More

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December 2017
11 Reads

Musical Interests and Talent: Twin Jazz Musicians and Twin Studies/Twin Research: Loss of a Preterm Multiple; Conjoined Twin Conception; Depression in Fathers of Twins; Twin-to-Twin Transfusion Syndrome/Twin News: High-Achieving Twins; Twin Children of a Tennis Star; Conjoined Twin Separation; Twin Delivery to a Giant Panda.

Authors:
Nancy L Segal

Twin Res Hum Genet 2017 Dec 6;20(6):643-648. Epub 2017 Nov 6.

Department of Psychology,California State University,Fullerton,CA,USA.

Findings from twin studies of musical interests and talent are reviewed as a backdrop to the lives and careers of twin jazz musicians, Peter and Will Anderson. The Anderson twins exemplify many aspects of twin research, namely their matched musical abilities, shared musical interests, and common career. This overview is followed by reviews of studies and case reports of bereavement in families who have lost a preterm multiple birth infant, the conception of conjoined twins following in vitro fertilization (IVF), depression in fathers of twins, and twin-to-twin transfusion incidence in monochorionic-diamniotic IVF twin pairs. Read More

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December 2017
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ACR Appropriateness Criteria Multiple Gestations.

J Am Coll Radiol 2017 Nov;14(11S):S476-S489

Valley Hospital, Ridgewood, New Jersey and NYU School of Medicine, New York, New York; American College of Obstetrics and Gynecology.

Women with twin or higher-order pregnancies will typically have more ultrasound examinations than women with a singleton pregnancy. Most women will have at minimum a first trimester scan, a nuchal translucency evaluation scan, fetal anatomy scan at 18 to 22 weeks, and one or more scans in the third trimester to evaluate growth. Multiple gestations are at higher risk for preterm delivery, congenital anomalies, fetal growth restriction, placenta previa, vasa previa, and velamentous cord insertion. Read More

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November 2017
13 Reads

Evaluation of dynamic thiol-disulfide homeostasis in very low-birth-weighted preterms.

J Matern Fetal Neonatal Med 2017 Nov 13:1-6. Epub 2017 Nov 13.

a Department of Neonatology , Etlik Zubeyde Hanım Women's Health Teaching and Research Hospital , Ankara , Turkey.

Background: Thiols are organic compounds containing sulfhydryl groups which exert antioxidant effects via dynamic thiol-disulfide homeostasis. The shift towards disulfides indicates the presence of oxidative environment. Thiol-disulfide homeostasis has not been evaluated in neonates. Read More

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November 2017
17 Reads

Aplasia cutis congenita as a result of interstitial laser therapy for fetal reduction in monochorionic twins: Conservative approach and outcome.

Int J Surg Case Rep 2017 10;41:68-70. Epub 2017 Oct 10.

Division of Neonatology, Faculty of Pediatrics, University of Calgary, Calgary, Canada. Electronic address:

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. Read More

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October 2017
5 Reads

Does site of cord insertion increase risk of adverse outcome, twin-to-twin transfusion syndrome and discordant growth in monochorionic twin pregnancy?

Ultrasound Obstet Gynecol 2018 Sep 5;52(3):385-389. Epub 2018 Aug 5.

Department of Obstetrics and Gynaecology, University Hospitals Leuven; Department of Development and Regeneration, KU Leuven, Leuven, Belgium.

Objectives: It is not currently well known to what extent the sites of cord insertion influence the risk of complicated outcome in monochorionic twin pregnancy. The objectives of this study were to examine whether the sites of cord insertion, as determined on prenatal ultrasound examination, affect the risks of adverse outcome, twin-to-twin transfusion syndrome (TTTS) and discordant growth, and whether discordance in insertion sites or velamentous insertion in one or both twins best predicts risk.

Methods: This was a retrospective cohort study of monochorionic diamniotic twin pregnancies followed from the first trimester. Read More

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September 2018
21 Reads