Document Detail


Intrauterine death of one twin, with rescue of the other, in twin-twin transfusion syndrome.
MedLine Citation:
PMID:  11896955     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Single intrauterine death may occur in twin-twin transfusion syndrome. We investigated why the outcome of the surviving twin is fairly good when the donor twin dies first compared with when the recipient twin dies first. A detailed hemodynamic study was performed using Doppler ultrasound in a twin pregnancy affected by twin-twin transfusion syndrome before and after a single intrauterine death that occurred in the donor twin at 26 weeks' gestation. The recipient twin was expected to die due to severe right cardiac failure with functional stenosis of the pulmonary artery 2 days before the cotwin's death. The donor twin's death caused a prompt resolution of cardiac failure and improvement in other indices, including flow velocity waveform patterns of the umbilical vein, the middle cerebral artery and the ductus venosus. A healthy, premature female neonate weighing 1630 g with a hemoglobin concentration of 17.8 g/dL was delivered by Cesarean section following rupture of the fetal membranes 28 days after the episode. Hemorrhaging from the surviving twin to the dead twin that occurred just before or after the cotwin's death may have contributed to the decrease in volume overload in the recipient twin, leading to a prompt amelioration of the critical hemodynamic indices. The early death of the donor twin may thus have played a significant role in improving the status of the recipient twin in this case of twin-twin transfusion syndrome.
Authors:
A Ohkuchi; H Minakami; H Shiraishi; I Suzuki; T Ohki; I Sato
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  19     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-03-18     Completed Date:  2002-05-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  293-6     Citation Subset:  IM    
Affiliation:
Center for Perinatal Medicine and Department of Obstetrics and Gynecology, Jichi Medical School Hospital, Minamikawachi-machi, Tochigi, Japan. okuchi@jichi.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Fetal Death
Fetofetal Transfusion / surgery*,  ultrasonography*
Follow-Up Studies
Humans
Pregnancy
Pregnancy Trimester, Second
Pregnancy, Multiple*
Risk Assessment
Twins
Ultrasonography, Prenatal*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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