Document Detail

Demonstration of placental vascular anatomy in monochorionic twin gestations.
MedLine Citation:
PMID:  11815867     Owner:  NLM     Status:  MEDLINE    
Invasive treatment modalities for severe chronic twin-to-twin transfusion syndrome (TTTS), such as fetoscopic laser coagulation of communicating vessels, have revived the need for detailed studies of placental angioarchitecture. We describe a practical placental vascular injection technique using alcohol-resistant tissue-staining dyes. Injection of color-coded gelatin-dye mixtures effectively delineated the intertwin vasculature, and allowed unequivocal macroscopic classification of vascular communications as artery-to-artery, vein-to-vein, or deep artery-to-vein anastomoses. The existence of deep artery-to-vein anastomoses was further confirmed by light microscopic demonstration of venous dye of one twin and arterial dye of the opposite twin within the same stem villus. Furthermore, the injection technique allowed determination of the caliber of the anastomoses, the direction of the artery-to-vein anastomoses, and the relative vascular territory of each twin. Documenting the vascular communications in monochorionic twin placentas with and without TTTS may enhance our understanding of the pathogenesis of chronic TTTS. Correlating the anastomotic patterns and location of the laser coagulation scars with post-ablation outcome will aid in the design of rational therapeutic methods for this often lethal condition.
Monique E De Paepe; Sarah Burke; Francois I Luks; Halit Pinar; Don B Singer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society     Volume:  5     ISSN:  1093-5266     ISO Abbreviation:  Pediatr. Dev. Pathol.     Publication Date:    2002 Jan-Feb
Date Detail:
Created Date:  2002-01-29     Completed Date:  2002-03-13     Revised Date:  2006-05-08    
Medline Journal Info:
Nlm Unique ID:  9809673     Medline TA:  Pediatr Dev Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  37-44     Citation Subset:  IM    
Department of Pathology, Women and Infants' Hospital, 101 Dudley Street, Providence, RI 02905, USA.
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MeSH Terms
Arteriovenous Anastomosis / pathology
Chorion / blood supply
Diseases in Twins
Fetofetal Transfusion / etiology,  pathology*
Gestational Age
Infant, Newborn
Placenta / blood supply*
Placental Circulation / physiology*
Twins, Dizygotic

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