Document Detail


Monoamniotic twin pregnancy discordant for lethal open cranial defect: management dilemmas.
MedLine Citation:
PMID:  21442629     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To report the sonographic findings, prenatal courses, and management options in four cases of monoamniotic twin pregnancy complicated by a discordant, lethal open cranial vault defect. METHODS: Cases were collected from two Latin American fetal medicine referral centers after the sonographic detection of a monoamniotic twin pregnancy in which one fetus was structurally normal and the other had a lethal open cranial vault defect. Three abnormal fetuses had acrania-anencephaly sequence and one had a large occipital encephalocele. The diagnosis was confirmed at referral, at which time umbilical cord entanglement was also diagnosed with color Doppler ultrasound in all cases. RESULTS: Two cases were managed with selective termination, one of which required referral to a fetal surgery center abroad because this option was illegal in Chile. The other case underwent radiofrequency ablation of the fetal intra-abdominal umbilical vessels after the corresponding ethics and legal committees approved the procedure. In both cases, the non-anomalous twin was born after 35 weeks and had no perinatal complications. Expectant management was performed in the other two cases, resulting in the death of the normal twin at 25 weeks. CONCLUSIONS: Monoamniotic twin pregnancy discordant for severe cranial vault defect is a serious condition with a high risk of fetal demise of the structurally normal fetus. Our experience, although limited, suggests that aggressive management with selective termination of the abnormal twin and transection of its umbilical cord in these cases may prevent the demise of the structurally normal co-twin. Copyright © 2011 John Wiley & Sons, Ltd.
Authors:
Waldo Sepulveda; Amy E Wong; Rodrigo Sandoval; Horacio Aiello; Lucas Otaño
Related Documents :
21176089 - Changes in fetal death during 40 years-different trends for different gestational ages:...
24754829 - Possible association of maternal factors with the higher risk of isolated true undescen...
8982719 - Turnover rate and stimulus-evoked release of dopamine by progesterone and n-methyl-d-as...
21370209 - Thrombophilia and pre-eclampsia.
2825609 - Contragestion by antiprogestin ru 486: a review.
24521459 - Benefits of repeated individual dietary counselling in long-term weight control in wome...
16551929 - Use of a modifier reduces inconsistency in the american society of anesthesiologists ph...
15073819 - Safety of acyclovir in general practice: a review of the literature.
10546309 - Explaining trends in teenage childbearing in sweden.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-27
Journal Detail:
Title:  Prenatal diagnosis     Volume:  -     ISSN:  1097-0223     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 John Wiley & Sons, Ltd.
Affiliation:
Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynecology, San Jose Hospital, University of Santiago de Chile, Santiago, Chile. fetalmed@yahoo.com.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Revisiting the risk for aneuploidy in fetuses with isolated pyelectasis.
Next Document:  Matrix stiffness modulates proliferation, chemotherapeutic response, and dormancy in hepatocellular ...