2,429 results match your criteria Twin-to-Twin Transfusion Syndrome


Maternal Anemia and Coagulation/Fibrinolysis after Fetoscopic Laser Photocoagulation for Twin-to-Twin Transfusion Syndrome.

Gynecol Obstet Invest 2019 Apr 9:1-8. Epub 2019 Apr 9.

Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Aim: This study was performed to evaluate maternal changes in laboratory characteristics after fetoscopic laser photocoagulation (FLP) for twin-to-twin transfusion syndrome (TTTS).

Methods: A retrospective review was conducted among 30 women with monochorionic diamniotic twin pregnancy with TTTS who underwent FLP at 16-26 weeks of gestation. Maternal laboratory parameters were measured before and after FLP. Read More

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http://dx.doi.org/10.1159/000499913DOI Listing
April 2019
1 Read

Congenital Laser-Induced Burns: A Potential Complication after Laser Photocoagulation in Monochorionic Twin Pregnancy.

Fetal Pediatr Pathol 2019 Apr 3:1-5. Epub 2019 Apr 3.

a Department of Neonatology , Hospital 12 de Octubre, Biomedical Research Institute i + 12 , Madrid , Spain.

Background: Fetoscopic laser photocoagulation can directly injure fetal skin and may at birth resemble aplasia cutis congenita (ACC).

Case Report: A twin monochorionic pregnancy was complicated by twin-to-twin transfusion syndrome requiring in utero laser photocoagulation, resulting in the death of one twin. After birth, the viable baby presented skin lesions in both legs that were congruent with laser-induced burns. Read More

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http://dx.doi.org/10.1080/15513815.2019.1588441DOI Listing
April 2019
1 Read

Postnatal Myocardial Function in Monochorionic Diamniotic Twins with Twin-to-Twin Transfusion Syndrome following Selective Laser Photocoagulation of the Communicating Placental Vessels.

J Am Soc Echocardiogr 2019 Mar 22. Epub 2019 Mar 22.

Department of Neonatology, The Rotunda Hospital, Dublin, Ireland; School of Medicine, Department of Pediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland. Electronic address:

Background: Monochorionic diamniotic (MCDA) twins are at risk for developing twin-to-twin transfusion syndrome (TTTS) throughout pregnancy. This may lead to myocardial dysfunction in the recipient and/or donor twin that persists beyond delivery. Selective laser photocoagulation of the communicating placental vessels (SLPCV) attempts to mitigate the cardiovascular outcomes. Read More

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http://dx.doi.org/10.1016/j.echo.2019.02.004DOI Listing
March 2019
1 Read

[Clinical features and prognosis of neonates with nonimmune hydrops fetalis].

Zhongguo Dang Dai Er Ke Za Zhi 2019 Mar;21(3):253-258

Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China.

Objective: To study the clinical features, etiology and prognosis of neonates with nonimmune hydrops fetalis (NIHF).

Methods: A retrospective analysis was performed for the clinical data and outcomes of 23 neonates with NIHF.

Results: Of the 23 neonates with NIHF, 18 (78%) were preterm infants and 5 (22%) were full-term infants; 12 (52%) had birth asphyxia (including 5 cases of severe asphyxia). Read More

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March 2019
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Quantitative fetal fibronectin to predict spontaneous preterm delivery after laser surgery for twin-twin transfusion syndrome.

Sci Rep 2019 Mar 14;9(1):4438. Epub 2019 Mar 14.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

Our goal was to assess whether quantitative fetal fibronectin (qfFN) is associated with spontaneous preterm birth (sPTB) after laser surgery for twin-twin transfusion syndrome (TTTS). qfFN was collected within 24 hours before and after laser surgery. Aims were: (1) To determine if qfFN changed with operative fetoscopy; and (2) To estimate the number of patients needed to study the predictive value of qfFN for sPTB <28 and <32 weeks. Read More

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http://dx.doi.org/10.1038/s41598-019-41163-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6418228PMC
March 2019
2 Reads

Predisposing factors and neonatal outcomes for twin-twin transfusion syndrome cases developing transient donor hydrops after fetoscopic laser coagulation: a case control study.

BMC Pregnancy Childbirth 2019 Mar 11;19(1):87. Epub 2019 Mar 11.

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan.

Background: Transient donor hydrops (TDH) is defined as donor hydrops developed within days after laser therapy for twin-twin transfusion syndrome (TTTS) followed by resolution later. The purpose of this study was to evaluate the incidence, neonatal outcomes and predisposing factors of post laser therapy TDH in severe TTTS.

Methods: A total of 142 patients with severe TTTS who received laser therapy were included into this study. Read More

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http://dx.doi.org/10.1186/s12884-019-2236-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419449PMC
March 2019
4 Reads

Acute twin-twin transfusion syndrome without labour.

J Obstet Gynaecol 2019 Mar 11:1-2. Epub 2019 Mar 11.

a Department of Obstetrics and Gynecology , Japanese Red Cross Katsushika Maternity Hospital , Tokyo , Japan.

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http://dx.doi.org/10.1080/01443615.2018.1555576DOI Listing

Update on twin-to-twin transfusion syndrome.

Best Pract Res Clin Obstet Gynaecol 2019 Jan 5. Epub 2019 Jan 5.

University Medical Center Hamburg-Eppendorf, Department of Obstetrics and Fetal Medicine, Hamburg, Germany.

Twin-to-twin transfusion syndrome (TTTS) is a serious complication that affects 10-15% of monochorionic multiple pregnancies. Communicating placental vessels on the chorionic plate between the donor and recipient twin are responsible for the imbalance of blood flow. There is evidence for the superiority of fetoscopic laser ablation over serial amnioreductions regarding survival and neurological outcome for stages II-IV TTTS. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15216934183024
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http://dx.doi.org/10.1016/j.bpobgyn.2018.12.011DOI Listing
January 2019
3 Reads

Twin anemia-polycythemia sequence with blood chimerism in monochorionic dizygotic opposite-sex twins.

J Obstet Gynaecol Res 2019 Feb 28. Epub 2019 Feb 28.

Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan.

We report a case of twin anemia-polycythemia sequence with blood chimerism in monochorionic dizygotic twins born to a 30-year-old woman who conceived via ovulation induction. The neonates developed twin anemia-polycythemia sequence; the female twin had anemia and the male had polycythemia. We detected blood chimerism using fluorescence in situ hybridization (FISH). Read More

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http://dx.doi.org/10.1111/jog.13949DOI Listing
February 2019
1 Read

Discordance of umbilical coiling index between recipients and donors in twin-twin transfusion syndrome.

Placenta 2019 Jan 18;76:19-22. Epub 2019 Jan 18.

Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Introduction: To compare the intertwin umbilical cord coiling in twin-twin transfusion syndrome (TTTS) before fetoscopic laser treatment and to correlate these with Doppler findings in both twins.

Methods: We performed a prospective study using three-dimensional (3D) ultrasound with color Doppler imaging of the umbilical cord in TTTS. Coiling index was measured as a reciprocal value of one complete vascular coil. Read More

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http://dx.doi.org/10.1016/j.placenta.2019.01.013DOI Listing
January 2019

[Analysis of clinical characteristics of discordant structural malformations in one of monochorionic diamnionic twins].

Zhonghua Fu Chan Ke Za Zhi 2019 Feb;54(2):87-92

Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.

To analyze the clinical characteristics of structural malformations in one of monochorionic diamnionic twins (MCDA). The clinical data of 77 MCDA patients with structural malformations diagnosed by ultrasound were retrospectively reviewed from January 2012 to May 2017. The distribution of structural malformations, prenatal chromosomal karyotyping and pregnancy outcomes were analyzed. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0529-567x.2019.02.003DOI Listing
February 2019
2 Reads

Twin-twin transfusion syndrome: need for mechanistic studies.

Am J Obstet Gynecol 2019 Feb 8. Epub 2019 Feb 8.

Department of Clinical Chemistry Hematology and Immunology, Diakonessenhuis, Utrecht, The Netherlands.

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http://dx.doi.org/10.1016/j.ajog.2019.02.007DOI Listing
February 2019
1 Read

Reply to: Twin-twin transfusion syndrome: need for mechanistic studies.

Am J Obstet Gynecol 2019 Feb 8. Epub 2019 Feb 8.

Centre for Women's & Children Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK, West Midlands Fetal Medicine Centre, Birmingham Women's and Children's NHS Foundation Trust, Mindelsohn Way, Edgbaston, B15 2TG, UK.

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http://dx.doi.org/10.1016/j.ajog.2019.02.008DOI Listing
February 2019
1 Read

Vascular transfer of lidocaine between monochorionic twins with no apparent signs.

Ultrasound Obstet Gynecol 2019 Feb 10. Epub 2019 Feb 10.

Center for Fetal Therapy - Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine Baltimore, Maryland, United States.

A 30-year old, nullipara presented with a dichorionic triamniotic triplet pregnancy at 18 weeks gestation with diagnosis of stage IV twin-twin transfusion syndrome (TTTS) and severe cervical shortening (cervical length of 4 mm). After extensive counselling she opted for selective reduction of the monochorionic pair and amnioreduction. This article is protected by copyright. Read More

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http://dx.doi.org/10.1002/uog.20237DOI Listing
February 2019
3 Reads

Maternal and neonatal outcomes according to gestational weight gain in twin pregnancies: Are the Institute of Medicine guidelines associated with better outcomes?

Eur J Obstet Gynecol Reprod Biol 2019 Mar 17;234:190-194. Epub 2019 Jan 17.

Centre Hospitalier Régional Universitaire de Lille, Hôpital Jeanne de Flandre, 2 Avenue Oscar Lambret, 59000, Lille, France; Université Lille2, CHRU Lille, EA 4489, Environnement Périnatal et Santé, F-59000, Lille, France.

Objective: The Institute of Medicine (IOM) recommended a gestational weight gain for full-term twin pregnancies of 17-25 kg for normal Body mass Index patients', and characterize its guidelines on during twin pregnancies as "provisional". Indeed, they are exclusively based on observational epidemiological data. The objective of this study was to investigate whether the IOM's gestational weight gain guidelines are optimal for maternal and neonatal. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S03012115193003
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http://dx.doi.org/10.1016/j.ejogrb.2019.01.010DOI Listing
March 2019
9 Reads

Characteristics of referred patients with twin-twin transfusion syndrome who did not undergo fetal therapy.

Prenat Diagn 2019 Mar 20;39(4):280-286. Epub 2019 Feb 20.

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.

Introduction: Abundant research has reported twin-twin transfusion syndrome (TTTS) outcomes following fetal therapy. Our research describes TTTS patients who did not undergo fetal therapy.

Methods: Records from TTTS pregnancies evaluated at 16 to 26 gestational weeks were reviewed between January 2006 and March 2017. Read More

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http://doi.wiley.com/10.1002/pd.5427
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http://dx.doi.org/10.1002/pd.5427DOI Listing
March 2019
5 Reads

Effect of intra-amniotic fluid pressure from polyhydramnios on cervical length in patients with twin-twin transfusion syndrome undergoing fetoscopic laser surgery.

Ultrasound Obstet Gynecol 2019 Jan 28. Epub 2019 Jan 28.

The Texas Fetal Center, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Medical School, Houston, TX.

Objective: To determine the relationship between intra-amniotic pressure (AP) and cervical length (CL) in patients with twin-twin transfusion syndrome undergoing fetoscopic laser photocoagulation (FLP).

Methods: Prospective cohort study of patients undergoing FLP for TTTS (N= 283; GA 20.7 ± 3 weeks; Stage I: 33, II: 88, III: 150, IV: 12) was performed. Read More

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http://dx.doi.org/10.1002/uog.20228DOI Listing
January 2019
4 Reads

Fetal Survival Immediate after Fetoscopic Laser Ablation in Twin to Twin Transfusion Syndrome.

J Korean Med Sci 2019 Jan 7;34(3):e20. Epub 2019 Jan 7.

Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.

Background: The purpose of this study was to determine prognostic factors that can affect the fetal survival immediate after fetoscopic laser ablation.

Methods: The study population consisted of consecutive twin pregnant women who underwent fetoscopic laser ablation with the diagnosis of twin to twin transfusion syndrome (TTTS) from 2011 to 2018 in Seoul National University Hospital. Fetal survival immediate after procedure was defined as survival to 48 hours after procedure and neonatal survival was defined as survival to 28 days of life. Read More

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http://dx.doi.org/10.3346/jkms.2019.34.e20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335125PMC
January 2019
2 Reads

Modified fetoscopic laser surgery in twin-to-twin transfusion syndrome with proximate cord insertions: a report of two cases and literature review.

J Matern Fetal Neonatal Med 2019 Jan 31:1-4. Epub 2019 Jan 31.

a Department of Obstetrics, Gynecology, and Reproductive Sciences , University of Maryland School of Medicine , Baltimore , MD , USA.

Proximate cord insertions (PxCIs) are a variant of umbilical cord insertions (CIs) that can be identified in monochorionic (MC) twins, making fetoscopic laser photocoagulation for twin-to-twin transfusion syndrome (TTTS) technically challenging. The existing literature is controversial for successful fetoscopic laser photocoagulation in TTTS cases with PxCIs. We presented two cases with TTTS complicated by PxCIs that underwent a successful laser ablation using our proposed technique. Read More

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http://dx.doi.org/10.1080/14767058.2019.1571578DOI Listing
January 2019
2 Reads

Blood chimerism in twins.

Immunohematology 2018 Dec;34(4):151-157

Blood Bank at University of Vale do Itajaí, Consultant and Evaluator of the National Hemonetwork Qualification Program (PNQH)/General Coordination of Blood and Hemoderivatives of the Ministry of Health, Itajaí, Brazil.

Conclusions: Chimerism is a phenomenon in which an individual has cells with different genetic content from different zygotes. In dizygotic twins (DTs), chimerism is believed to occur through placental anastomoses that enable the bidirectional exchange of hematopoietic stem cells. Little is still known about chimerism frequency in twins, but several studies have shown a relation between chimerism and some conditions such as autism, Alzheimer's disease, and a group of autoimmune diseases such as Sjögren syndrome, systemic lupus erythematosus, and systemic sclerosis. Read More

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December 2018
6 Reads

Mirroring preeclampsia: the molecular basis of Ballantyne syndrome.

J Matern Fetal Neonatal Med 2019 Jan 6:1-6. Epub 2019 Jan 6.

e Perinatal Research Centre , The Royal Women's Hospital , Melbourne , Australia.

Objectives: The purpose of this article was to further elucidate the pathophysiology of Mirror (Ballantyne) syndrome within the context of known biomarkers for preeclampsia.

Methods: This novel insight from clinical practice involved a case of post-twin-to-twin transfusion syndrome-laser hydrops in an ex-donor twin, corroborated by histopathologic placental territory edema and maternal sequelae of Mirror syndrome. We serially measured the levels of activin A, follistatin, endothelin-1 (ET-1), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), soluble fms-like tyrosine kinase 1 (sFlt), and von Willebrand factor (vWF) in the maternal serum from disease evolution through to recovery. Read More

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http://dx.doi.org/10.1080/14767058.2018.1500550DOI Listing
January 2019
3 Reads

An ultrasonographic estimated fetal weight reference for Japanese twin pregnancies.

J Med Ultrason (2001) 2019 Apr 27;46(2):209-215. Epub 2018 Dec 27.

Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.

Purpose: The purpose was to establish an estimated fetal weight (EFW) reference for twin pregnancies in Japan and to compare the growth of twins with singletons.

Methods: We retrospectively investigated Japanese women who delivered live-born twins at our center during the period from 2010 to 2016. The main exclusion criteria were monoamniotic twins, fetal reduction, maternal complications, twin-twin transfusion syndrome, fetal congenital anomalies, and patients with their first visit after 16 weeks' gestation. Read More

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http://dx.doi.org/10.1007/s10396-018-0921-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6438934PMC
April 2019
1 Read

Bronchopulmonary Sequestration with Fetal Hydrops in a Monochorionic Twin Successfully Treated with Multiple Courses of Betamethasone.

AJP Rep 2018 Oct 3;8(4):e359-e361. Epub 2018 Dec 3.

Department of Gynaecology and Obstetrics, Third Faculty of Medicine, Charles University, Prague, Czech Republic.

 We present a case of severe bronchopulmonary sequestration (BPS) and fetal hydrops in one of the monochorionic twin successfully treated with multiple courses of betamethasone.  A 21-year-old gravida 2 para 1 was referred to our hospital for suspected twin-to-twin transfusion syndrome (TTTS) at 28 weeks of gestational age. However, prenatal ultrasound of the larger twin revealed a chest lesion that was associated with significant ascites, massive hydrothorax, scant hepatomegaly, subcutaneous edema, and severe polyhydramnios. Read More

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http://dx.doi.org/10.1055/s-0038-1676339DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277237PMC
October 2018
3 Reads

Twin-to-Twin Transfusion Syndrome: A Case Report.

Neonatal Netw 2018 Sep 1;37(5):292-302. Epub 2018 Sep 1.

Purpose: To present a case of twin-to-twin transfusion syndrome (TTTS), followed by discussion of the etiology, pathophysiology, prenatal diagnosis, management, complications, prognosis, and family considerations.

Methods: A literature review was conducted using MEDLINE, PubMed, CINAHL, ProQuest, and Google Scholar. The search resulted in 593 articles; 25 relevant articles were chosen. Read More

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http://connect.springerpub.com/lookup/doi/10.1891/0730-0832.
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http://dx.doi.org/10.1891/0730-0832.37.5.292DOI Listing
September 2018
7 Reads

Chronic kidney disease following twin-to-twin transfusion syndrome-long-term outcomes.

Pediatr Nephrol 2019 May 17;34(5):883-888. Epub 2018 Dec 17.

Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK.

Background: Amongst other sequelae, acute kidney injury (AKI) is a well-recognised post-natal complication of twin-to-twin transfusion syndrome (TTTS). Despite this, there has been a lack of data reporting long-term renal outcomes. Our aim was to report the long-term renal outcomes of infants born with TTTS. Read More

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http://dx.doi.org/10.1007/s00467-018-4176-zDOI Listing
May 2019
1 Read

Isolated Ascites in a Monochorionic Twin after Fetoscopic Laser Ablation Is Not Necessarily Secondary to Recurrence or Anaemia: Bowel Complications in Twin-to-Twin Transfusion Syndrome after Fetoscopic Laser Ablation.

Fetal Diagn Ther 2018 Dec 14:1-10. Epub 2018 Dec 14.

Fetal Medicine Centre, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom.

Background/purpose: We report a case study of jejunal atresia and the results of a systematic literature review of all reported cases of bowel complications occurring after fetoscopic laser ablation (FLA) for the treatment of twin-to-twin transfusion syndrome (TTTS).

Methods: A systematic literature review was performed of bowel complications after FLA for TTTS according to PRISMA guidelines.

Results: There are 11 published cases of small bowel atresia, 5 cases of necrotising enterocolitis (NEC), and 2 cases with foetal bowel perforations. Read More

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https://www.karger.com/Article/FullText/494616
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http://dx.doi.org/10.1159/000494616DOI Listing
December 2018
14 Reads

Twin-to-twin transfusion syndrome in dichorionic twin pregnancy: rare but not impossible.

Ultrasound Obstet Gynecol 2018 Dec 14. Epub 2018 Dec 14.

Fetal therapy Unit "U. Nicolini", Vittore Buzzi Children's Hospital, Università di Milano, Milan, Italy.

Twin-to-twin transfusion syndrome (TTTS) is a typical complication of monochorionic (MC) twin pregnancy related to the presence of vascular anastomosis on the surface of the shared placenta . This article is protected by copyright. All rights reserved. Read More

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http://dx.doi.org/10.1002/uog.20195DOI Listing
December 2018
1 Read

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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http://doi.wiley.com/10.1002/uog.20183
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http://dx.doi.org/10.1002/uog.20183DOI Listing
December 2018
14 Reads

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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http://dx.doi.org/10.1213/ANE.0000000000003947DOI Listing
November 2018
2 Reads

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

Int J Comput Assist Radiol Surg 2019 Feb 27;14(2):227-235. 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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http://link.springer.com/10.1007/s11548-018-1886-4
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http://dx.doi.org/10.1007/s11548-018-1886-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6438174PMC
February 2019
3 Reads

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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http://journals.sagepub.com/doi/10.1177/1742271X18794013
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http://dx.doi.org/10.1177/1742271X18794013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6243450PMC
November 2018
13 Reads

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

Acta Obstet Gynecol Scand 2019 Apr 17;98(4):479-486. Epub 2018 Dec 17.

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 prospectively analyzed the 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. Read More

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http://dx.doi.org/10.1111/aogs.13509DOI Listing
April 2019
23 Reads

Fetal stroke and cerebrovascular disease: Advances in understanding from lenticulostriate and venous imaging, alloimmune thrombocytopaenia and monochorionic twins.

Eur J Paediatr Neurol 2018 Nov 11;22(6):989-1005. Epub 2018 Sep 11.

Departments of Child Health, Obstetrics and Gynaecology and Radiology, University Hospital Southampton, United Kingdom; Clinical and Experimental Sciences, University of Southampton, United Kingdom.

Fetal stroke is an important cause of cerebral palsy but is difficult to diagnose unless imaging is undertaken in pregnancies at risk because of known maternal or fetal disorders. Fetal ultrasound or magnetic resonance imaging may show haemorrhage or ischaemic lesions including multicystic encephalomalacia and focal porencephaly. Serial imaging has shown the development of malformations including schizencephaly and polymicrogyra after ischaemic and haemorrhagic stroke. Read More

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http://dx.doi.org/10.1016/j.ejpn.2018.08.008DOI Listing
November 2018
15 Reads

Prognosis of the co-twin following spontaneous single intrauterine fetal death in twin pregnancies: a systematic review and meta-analysis.

BJOG 2019 Apr 26;126(5):569-578. Epub 2018 Nov 26.

Centre for Women's and Children Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.

Background: Single intrauterine fetal death affects approximately 6% of twin pregnancies and can have serious sequelae for the surviving co-twin.

Objectives: Determine the prognosis of the surviving co-twin following spontaneous single intrauterine fetal death to aid counselling patients and highlight future research areas.

Search Strategy: Medline, Embase, Web of Science, and Cochrane Library, from 1980 to June 2017. Read More

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http://dx.doi.org/10.1111/1471-0528.15530DOI Listing
April 2019
6 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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http://dx.doi.org/10.1080/14767058.2018.1551350DOI Listing
November 2018
17 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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https://linkinghub.elsevier.com/retrieve/pii/S08995885183097
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http://dx.doi.org/10.1016/j.cnc.2018.07.006DOI Listing
December 2018
15 Reads

Fatal Umbilical Cord Strangulation in the Remaining Co-Twin after Selective Foeticide with Radiofrequency Ablation for Twin-Twin Transfusion Syndrome.

Fetal Diagn Ther 2018 Nov 12:1-4. Epub 2018 Nov 12.

Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.

We report a case of a monochorionic diamniotic twin diagnosed with twin-twin transfusion syndrome (TTTS; stage 3) with co-existing severe cerebral damage in the donor twin at 18 + 4 weeks' gestation. After counselling, the parents opted for selective foeticide of the donor twin. For the procedure, radiofrequency ablation (RFA) was used. Read More

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http://dx.doi.org/10.1159/000493790DOI Listing
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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https://www.tandfonline.com/doi/full/10.1080/14767058.2018.1
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http://dx.doi.org/10.1080/14767058.2018.1534954DOI Listing
November 2018
6 Reads

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

Med Image Anal 2019 01 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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https://linkinghub.elsevier.com/retrieve/pii/S13618415183084
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http://dx.doi.org/10.1016/j.media.2018.10.003DOI Listing
January 2019
16 Reads

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

Twin Res Hum Genet 2018 12 30;21(6):546-555. 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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http://dx.doi.org/10.1017/thg.2018.58DOI Listing
December 2018
6 Reads

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

Prenat Diagn 2018 12 28;38(13):1013-1019. Epub 2018 Nov 28.

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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http://doi.wiley.com/10.1002/pd.5378
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http://dx.doi.org/10.1002/pd.5378DOI Listing
December 2018
12 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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http://dx.doi.org/10.1136/archdischild-2017-314497DOI Listing
October 2018
4 Reads

Maternal sickle cell disease and twin pregnancy: a case series and review of the literature.

Hematology 2019 Dec 21;24(1):148-158. Epub 2018 Oct 21.

d Women's Health, St. Thomas' Hospital, King's Health Partners, Guy's and St Thomas' NHS Foundation Trust , London , UK.

Objectives: Maternal sickle cell disease (SCD) and multiple gestations are well known separately as causes of high-risk pregnancies, however, there is sparse information available on maternal and perinatal outcome when both conditions occur together. This case series describes the outcomes of women with maternal SCD and twin pregnancy in the largest single-center case series to date.

Methods: Retrospective identification of all twin pregnancies in maternal SCD patients between 2006 and 2016 at Guy's and St. Read More

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http://dx.doi.org/10.1080/10245332.2018.1535534DOI Listing
December 2019
6 Reads

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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http://link.springer.com/10.1007/s12574-018-0401-9
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http://dx.doi.org/10.1007/s12574-018-0401-9DOI Listing
October 2018
7 Reads

The incidence of unexpected critical complications in monochorionic diamniotic twin pregnancies according to the interval period between ultrasonographic evaluations.

J Obstet Gynaecol Res 2019 Feb 10;45(2):318-324. Epub 2018 Oct 10.

Department of Maternal Fetal Medicine, Osaka Women's and Children's Hospital, Osaka, Japan.

Aim: This study aimed to evaluate the incidence of unexpected critical complications (UCC) in monochorionic diamniotic (MCDA) twin pregnancies according to ultrasonographic scan interval.

Methods: This retrospective single-center cohort study, conducted between January 2005 and April 2015, investigated the incidence of UCC in patients with MCDA twin pregnancies undergoing weekly ultrasound (Group A) and those undergoing biweekly ultrasound (Group B). We also examined the incidence of predictable critical complications according to ultrasound interval. Read More

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http://doi.wiley.com/10.1111/jog.13827
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http://dx.doi.org/10.1111/jog.13827DOI Listing
February 2019
6 Reads

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

Osteoporos Int 2018 Nov 11;29(11):2575-2579. 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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http://dx.doi.org/10.1007/s00198-018-4639-xDOI Listing
November 2018
3 Reads

Are complicated monochorionic twins more susceptible to indomethacin-induced fetal ductal constriction? Two cases of laser surgery for Twin-Twin Transfusion syndrome.

Turk J Obstet Gynecol 2018 Sep 3;15(3):200-203. Epub 2018 Sep 3.

İstanbul University Cerrahpaşa Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Perinatal Medicine, İstanbul, Turkey.

Indomethacin is a commonly used medication against preterm delivery. Several reports of fetal ductal constriction have been described after indomethacin use in the literature; however, there are no previously documented reports describing an association between Twin-Twin Transfusion syndrome and a constrictor effect of indomethacin on the ductus arteriosus. Two patients were referred to our department for Twin-Twin Transfusion syndrome and each underwent placental laser surgery. Read More

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http://dx.doi.org/10.4274/tjod.78095DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127469PMC
September 2018
3 Reads

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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http://dx.doi.org/10.1080/14767058.2018.1506441DOI Listing
September 2018
5 Reads

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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http://dx.doi.org/10.7759/cureus.2910DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122656PMC
July 2018
13 Reads

Outcomes of extremely premature infants with twin-twin transfusion syndrome treated by laser therapy.

J Perinatol 2018 Nov 3;38(11):1548-1555. Epub 2018 Sep 3.

Department of Pediatrics, Division of Neonatology, CHU Sainte-Justine, Université de Montréal, Montréal, QC, Canada.

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. Read More

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http://dx.doi.org/10.1038/s41372-018-0202-zDOI Listing
November 2018
6 Reads