Document Detail


Monochorionic twin pregnancy: screening, pathogenesis of complications and management in the era of microinvasive fetal surgery.
MedLine Citation:
PMID:  20629496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The management of monochorionic (MC) twin pregnancies varies in different medical centers. This paper compares screening methods to predict the complications of the MC twin pregnancy and different treatment methods.
METHODS: We performed a literature search without language restriction in Cochrane library and PubMed (1970-2009). Case series and cohort screening studies, pathogenesis and management of complications of MC pregnancy were included.
RESULTS: Elevated risk for intrauterine fetal death (IUFD) and twin-to-twin transfusion syndrome (TTTS) can be detected sonographically. Monitoring of MC pregnancies at increased risk and regular training sessions for the operating team combined with reduced fetoscopic amniotic membrane damage increase fetal survival rate from laser coagulation to nearly 100% for at least one fetus and to 90% for both.
CONCLUSION: Monitoring of MC pregnancies at increased risk and laser treatment of TTTS in medical centers with sufficient experience might improve neonatal outcome.
Authors:
Michael Tchirikov
Publication Detail:
Type:  Journal Article; Review; Twin Study    
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  38     ISSN:  1619-3997     ISO Abbreviation:  J Perinat Med     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-03     Completed Date:  2011-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  451-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Fetal Medicine, Clinic of Obstetrics and Gynecology, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany. tchirikov@uni-mainz.de
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MeSH Terms
Descriptor/Qualifier:
Amnion / ultrasonography
Chorion / ultrasonography
Female
Fetal Growth Retardation / etiology,  therapy
Fetal Therapies / instrumentation,  methods*
Fetofetal Transfusion / diagnosis,  etiology,  therapy
Humans
Infant, Newborn
Laser Coagulation / instrumentation,  methods
Male
Models, Biological
Pregnancy
Pregnancy Complications / diagnosis*,  etiology,  therapy*
Pregnancy, Multiple*
Prenatal Diagnosis
Twins, Monozygotic*

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