Document Detail

Specific complications of monochorionic twin pregnancies: twin-twin transfusion syndrome and twin reversed arterial perfusion sequence.
MedLine Citation:
PMID:  20855238     Owner:  NLM     Status:  MEDLINE    
Monochorionic twins are subjected to specific complications which originate in either imbalance or abnormality of the single placenta serving two twins. This unequal placental sharing can cause complications including twin-twin transfusion syndrome (TTTS), twin anemia-polycythemia sequence (TAPS), selective intrauterine growth restriction or twin reversed arterial perfusion sequence (TRAP). Monochorionicity also makes the management of these specific complications as well as that of a severe malformation in one twin hazardous since the spontaneous death of one twin exposes the co-twin to a risk of exsanguination into the dead twin and its placenta. The latter is responsible for the death of the co-twin in up to 20% of the cases and in ischemic sequelae in about the same proportions in the survivors. Although the symptoms of all these complications are very different, the keystone of their management comes down to either surgical destruction of the inter-twin anastomoses on the chorionic plate when aiming at dual survival or selective and permanent occlusion of the cord of a severely affected twin aiming at protecting the normal co-twin. This can be best achieved by fetoscopic selective laser coagulation and bipolar forceps cord coagulation respectively.
G E Chalouhi; J J Stirnemann; L J Salomon; M Essaoui; T Quibel; Y Ville
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Publication Detail:
Type:  Journal Article; Review     Date:  2010-09-19
Journal Detail:
Title:  Seminars in fetal & neonatal medicine     Volume:  15     ISSN:  1878-0946     ISO Abbreviation:  Semin Fetal Neonatal Med     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-10-18     Completed Date:  2011-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101240003     Medline TA:  Semin Fetal Neonatal Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  349-56     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ltd. All rights reserved.
National Referral Centre for TTTS, Université Paris-Descartes, GHU Necker-Enfants-Malades, 149 Rue de Sèvres, 75015 Paris, France.
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MeSH Terms
Ablation Techniques
Diseases in Twins* / diagnosis,  surgery
Fetofetal Transfusion* / diagnosis,  surgery
Fetoscopy* / adverse effects,  methods
Placenta / blood supply*
Prenatal Diagnosis
Twins, Monozygotic*
Vascular Fistula* / diagnosis,  surgery

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