Staging of twin-twin transfusion syndrome.
Rubén A. Quintero,Walter J. Morales,Mary H. Allen,Patricia W. Bornick,Patricia K Johnson,Michael Kruger +5 more
TLDR
Staging of TT TS using the proposed criteria has prognostic significance and may allow comparison of outcome data of TTTS with different treatment modalities.Abstract:
Objective The purpose of this study was to evaluate the prognostic value of sonographic and clinical parameters to develop a staging classification of twin-twin transfusion syndrome (TTTS). Study design Severe TTTS was defined as the presence of polyhydramnios (maximum vertical pocket of > or = 8 cm) and oligohydramnios (maximum vertical pocket of Results A total of 80 of 108 referred patients met criteria for surgery, but only 65 were treated surgically: 48 with LPCV and 17 with umbilical cord ligation. Complete Doppler data were obtainable in 41 of 48 LPCV patients. Survival rates by stage for one or two fetuses were statistically different (chi-squared analysis = 12.9, df = 6, p = 0.044). Neither percent size discordance nor gestational age at diagnosis were predictive of outcome. Conclusion Staging of TTTS using the proposed criteria has prognostic significance. This staging system may allow comparison of outcome data of TTTS with different treatment modalities.read more
Citations
More filters
Journal ArticleDOI
Endoscopic laser surgery versus serial amnioreduction for severe twin-to-twin transfusion syndrome
TL;DR: Endoscopic laser coagulation of anastomoses is a more effective first-line treatment than serial amnioreduction for severe twin-to-twin transfusion syndrome diagnosed before 26 weeks of gestation.
Journal ArticleDOI
Diagnosis and Treatment of Fetal Cardiac Disease A Scientific Statement From the American Heart Association
Mary T. Donofrio,Anita J. Moon-Grady,Lisa K. Hornberger,Joshua A. Copel,Mark Sklansky,Alfred Abuhamad,Bettina F. Cuneo,James C. Huhta,Richard A. Jonas,Anita Krishnan,Stephanie Lacey,Wesley Lee,Erik C. Michelfelder,Gwen R. Rempel,Norman H. Silverman,Thomas L. Spray,Janette F. Strasburger,Wayne Tworetzky,Jack Rychik +18 more
TL;DR: This statement highlights what is currently known and recommended on the basis of evidence and experience in the rapidly advancing and highly specialized field of fetal cardiac care.
Journal ArticleDOI
The outcome of monochorionic diamniotic twin gestations in the era of invasive fetal therapy: a prospective cohort study.
Liesbeth Lewi,Jacques Jani,Isaac Blickstein,A. Huber,Leonardo Gucciardo,Tim Van Mieghem,Elisa Done,Anne-Sophie Boes,Kurt Hecher,E. Gratacós,Paul Lewi,Jan Deprest +11 more
TL;DR: Most losses were at 24 weeks or less, and TTTS was the most important cause of death, and the risk of intrauterine demise appears to be small after 32 weeks.
Journal ArticleDOI
ISUOG Practice Guidelines: role of ultrasound in twin pregnancy.
Asma Khalil,M. Rodgers,Ahmet Baschat,Amar Bhide,Eduard Gratacós,Kurt Hecher,Mark D. Kilby,Liesbeth Lewi,Kypros H. Nicolaides,Dick Oepkes,Nick Raine-Fenning,Keith Reed,Laurent Salomon,Alexandros Sotiriadis,B. Thilaganathan,Yves Ville +15 more
TL;DR: The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) is a scientific organization that encourages sound clinical practice, and high quality teaching and research related to diagnostic imaging in women's healthcare.
Journal ArticleDOI
Prevalence and management of late fetal complications following successful selective laser coagulation of chorionic plate anastomoses in twin-to-twin transfusion syndrome.
R. Robyr,Liesbeth Lewi,Laurent Salomon,M. Yamamoto,Jean-Pierre Bernard,Jan Deprest,Yves Ville +6 more
TL;DR: MCA-PSV Doppler measurements are useful in the follow-up of double survivors to detect and manage late complications after selective laser therapy.
References
More filters
Journal ArticleDOI
Preliminary experience with endoscopic laser surgery for severe twin-twin transfusion syndrome
TL;DR: This condition can now be treated by endoscopic coagulation of the vascular anastomoses responsible for fetofetal transfusion with a neodymium:yttrium–aluminum–garnet (Nd:YAG) laser.
Journal ArticleDOI
Selective photocoagulation of placental vessels in twin-twin transfusion syndrome: evolution of a surgical technique.
Rubén A. Quintero,Walter J. Morales,Gustavo Mendoza,Mary H. Allen,Craig S. Kalter,Gregg Giannina,J L Angel +6 more
Journal ArticleDOI
Preliminary Experience With Endoscopic Laser Surgery for Severe Twin-Twin Transfusion Syndrome
TL;DR: The preliminary experience suggests that the twin-twin transfusion syndrome can be treated effectively by endoscopic laser coagulation of the communicating placental vessels.
Journal ArticleDOI
In utero percutaneous umbilical cord ligation in the management of complicated monochorionic multiple gestations
Ruben A. Quintero,Roberto Romero,Roberto Romero,H. Reich,Luís F. Gonçalves,Mark P. Johnson,Carlos A. Carreno,M. I. Evans +7 more
TL;DR: The study was designed to report the experience with in utero percutaneous umbilical cord ligation for selective feticide in pre‐viable, abnormal, monochorionic multiple gestations and to select patients for evaluation and possible treatment.
Journal ArticleDOI
Doppler studies of the fetal circulation in twin-twin transfusion syndrome.
TL;DR: Alterations in the donor's circulation are consistent with decreased venous return due to hypovolemia and increased cardiac afterload due to increased placental resistance, and the recipient's circulation showed the characteristics of congestive heart failure due to hypervolemia.