| Occlusion of arterio-arterial anastomosis manifesting as acute twin-twin transfusion syndrome. | |
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MedLine Citation:
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PMID: 14972456 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In vivo, ex vivo and modelling studies suggest that arterio-arterial anastomoses (AAAs) protect against haemodynamic imbalance in monochorionic twins and thus the development of TTTS. We report the acute onset of severe TTTS at 34 weeks' gestation in a patient with an antenatally visualized AAA which was shown at injection studies to have been obliterated, presumably by thrombosis. Computer modelling with the relevant clinical data confirmed that occlusion of the AAA alone was sufficient to reproduce the clinical manifestations. A study of the vascular configuration of AAA in the fixed placenta suggested that its small diameter and turbulent flow may have contributed to its occlusion. This case report shows that the unmasking of unbalanced AVA configurations by occlusion of a protective AAA can manifest as TTTS. |
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Authors:
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T Y T Tan; M L Denbow; P M Cox; D Talbert; N M Fisk |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Placenta Volume: 25 ISSN: 0143-4004 ISO Abbreviation: Placenta Publication Date: 2004 Feb-Mar |
Date Detail:
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Created Date: 2004-02-19 Completed Date: 2004-09-28 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8006349 Medline TA: Placenta Country: England |
Other Details:
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Languages: eng Pagination: 238-42 Citation Subset: IM |
Affiliation:
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Institute of Reproductive and Developmental Biology, Imperial College, Hammersmith Campus, London, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Arterio-Arterial Fistula
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complications,
pathology*,
physiopathology Female Fetofetal Transfusion / pathology*, physiopathology, prevention & control Gestational Age Hemodynamics / physiology Humans Maternal Age Microcirculation / physiology Placenta / blood supply* Placental Insufficiency / etiology, pathology*, physiopathology Pregnancy Pregnancy Outcome Pregnancy, High-Risk Thrombosis / complications, pathology, physiopathology Twins, Monozygotic* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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