Document Detail


Stuck twin with cotwin nonimmune hydrops: successful treatment by amniocentesis.
MedLine Citation:
PMID:  1789918     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Until the recent introduction of therapeutic amniocentesis, pregnancies complicated by the stuck twin phenomenon usually suffered poor outcomes. We report the first case in which a single amniocentesis of the cotwin was followed by equalization of amniotic fluid volume in both sacs, resolution of nonimmune hydrops in the cotwin, and delivery of 2 healthy infants. The cause of the phenomenon in this was most likely severe twin-twin transfusion, based on a negative hematologic and serologic immune and nonimmune hydrops evaluation, and placental histology revealing a superficial large-caliber arteriovenous anastomosis joining the twins' circulations without an intervening capillary bed. The mechanism proposed for the physiologic response in this case to therapeutic amniocentesis is based on the correction of abnormal amniotic fluid volumes and pressures. This contention is supported by histologic evaluation of the placenta and the intrapartum fetal heart rate tracing.
Authors:
J R Wax; K J Blakemore; P Blohm; N A Callan
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Fetal diagnosis and therapy     Volume:  6     ISSN:  1015-3837     ISO Abbreviation:  Fetal. Diagn. Ther.     Publication Date:  1991  
Date Detail:
Created Date:  1992-03-30     Completed Date:  1992-03-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9107463     Medline TA:  Fetal Diagn Ther     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  126-31     Citation Subset:  IM    
Affiliation:
Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, Md.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniocentesis*
Amniotic Fluid / physiology
Ascites / complications,  therapy,  ultrasonography
Female
Fetofetal Transfusion / complications,  therapy,  ultrasonography
Humans
Hydrops Fetalis / complications,  therapy*,  ultrasonography
Infant, Newborn
Male
Oligohydramnios / complications,  therapy,  ultrasonography
Polyhydramnios / complications,  therapy,  ultrasonography
Pregnancy
Pressure

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


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