| In vivo endoscopic assessment of arterioarterial anastomoses: insight into their hemodynamic function. | |
| | |
MedLine Citation:
|
PMID: 14738171 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To assess endoscopically the hemodynamic function of arterioarterial (AA) anastomoses in twin-twin transfusion syndrome (TTTS) and monochorionic selective intrauterine growth restriction (IUGR). MATERIALS AND METHODS: The videotapes of TTTS and IUGR patients undergoing laser surgery between July 1997 and December 2001 were reviewed for the presence of AA anastomoses. The hemodynamic equator was defined as the site within the AA anastomosis with color flashing. AA anastomoses were classified as having unidirectional flow, having bi-directional flow, or being non-functional, depending on whether the hemodynamic equator reached a returning vein to one, both, or neither twin, respectively. TTTS was classified in stages as previously described. RESULTS: AA anastomoses were present in 35/183 (19.1%) of TTTS and in 12/24 (50%) IUGR patients. Of these, the hemodynamic equator was visible in 8/35 (22.8%) TTTS patients (all in stage III, and mostly in atypical stage III) and in 6/12 (50%) IUGR patients (overall 14/47, 29.8%). Of the 14 patients with a visible hemodynamic equator, 13 (92.8%) AA anastomoses showed unidirectional (9/13, 69.2% from the smaller to the larger twin) flow, and only 1/14 (7.1%) showed bi-directional flow. CONCLUSION: The hemodynamic equator is visible in approximately 30% of patients with AA anastomoses. Within this group, most AA anastomoses behave as functional arteriovenous anastomoses, and the direction of flow can be from the smaller to the larger twin or vice versa. The data suggest a correlation between sonographic findings and placental vascular design, also implying possible interfetal oxygenation differences. Further assessment of the functional behavior of AA anastomoses is warranted to understand the pathophysiology of TTTS and selective IUGR. |
| | |
Authors:
|
T Murakoshi; R A Quintero; P W Bornick; M H Allen |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians Volume: 14 ISSN: 1476-7058 ISO Abbreviation: J. Matern. Fetal. Neonatal. Med. Publication Date: 2003 Oct |
Date Detail:
|
Created Date: 2004-01-23 Completed Date: 2004-02-06 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 101136916 Medline TA: J Matern Fetal Neonatal Med Country: United States |
Other Details:
|
Languages: eng Pagination: 247-55 Citation Subset: IM |
Affiliation:
|
Florida Institute for Fetal Diagnosis and Therapy, St. Joseph's Women's Hospital, Tampa, Florida, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Arteriovenous Anastomosis / physiopathology* Female Fetal Growth Retardation / physiopathology* Fetofetal Transfusion / physiopathology* Gestational Age Hemodynamics Humans Pregnancy Prenatal Diagnosis Videotape Recording |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Unexplained fetal death is associated with changes in the adaptive limb of the maternal immune respo...
Next Document: Continuous glucose monitoring for the evaluation and improved control of gestational diabetes mellit...