Document Detail


Treatment of twin-twin transfusion syndrome by laser and digoxin. Biophysical and angiographic evaluation.
MedLine Citation:
PMID:  9708434     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: A combination of surgical and medical approaches may address both the underlying pathophysiological processes and the most threatening symptoms in twin-twin transfusion syndrome (TTTS). CASE: A primigravida with monochorionic twin pregnancy was referred with signs of TTTS at 16 weeks. One twin was severely hydropic with normal amniotic fluid, the co-twin had anhydramnios. Laser treatment was performed. Nevertheless, signs of severe cardiac decompensation in the recipient remained unchanged. After treatment with digoxin restoration of congestive heart failure and a resolution of the hydrops were achieved. Activity and inter-twin contacts increased significantly. At 37 weeks 2 healthy boys were delivered. Postnatal computerangiography of the placenta revealed no arteriovenous anastomoses. CONCLUSIONS: This case suggests that a combined causal and symptomatic therapy in cases with cardiac decompensation of the recipient can be beneficial as demonstrated by echocardiography, venous Doppler and behavioral analysis. Computer angiography of the placenta may demonstrate the effect of laser treatment.
Authors:
B Arabin; R N Laurini; J van Eyck; K H Nicolaides
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Fetal diagnosis and therapy     Volume:  13     ISSN:  1015-3837     ISO Abbreviation:  Fetal. Diagn. Ther.     Publication Date:    1998 May-Jun
Date Detail:
Created Date:  1998-10-08     Completed Date:  1998-10-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9107463     Medline TA:  Fetal Diagn Ther     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  141-6     Citation Subset:  IM    
Affiliation:
Department of Perinatology Sophia Ziekenhuis, Zwolle, The Netherlands. clara-angela@pi.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiotonic Agents / therapeutic use*
Combined Modality Therapy
Digoxin / therapeutic use*
Diseases in Twins / therapy*
Female
Fetofetal Transfusion / complications,  drug therapy*,  surgery*
Heart Failure / drug therapy*,  etiology
Humans
Laser Therapy*
Male
Pregnancy
Twins, Monozygotic
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 20830-75-5/Digoxin

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


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