Abstract
Objectives: Twin-twin transfusion syndrome (TTTS) is associated with a high risk of perinatal morbidity and mortality. The condition results from intertwin vascular connections in the shared placenta. We report here a case of early, severe TTTS that failed to respond to serial amniocenteses and that was successfully treated by means of superselective laser coagulation. Methods: A causative arteriovenous anastomosis was identified by means of prenatal obstetrical sonography, using color and spectral Doppler techniques. At fetoscopy, performed at 23 weeks' gestation, laser occlusion of only this connection was achieved. Results: This therapeutic intervention resulted in rapid resolution of all evidence of TTTS and a successful pregnancy outcome, with subsequent delivery of 2 healthy infants at 33 weeks' gestation. Conclusions: The potentially fatal pathophysiology of TTTS was reversed by interruption of a single arteriovenous connection. We have termed this the sonographically evaluated, laser-endoscopic coagulation for twins ('Select') procedure. Copyright (C) 2000 S. Karger AG, Basel.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 257-261 |
| Number of pages | 5 |
| Journal | Fetal Diagnosis and Therapy |
| Volume | 15 |
| Issue number | 5 |
| State | Published - Sep 2000 |
Fingerprint
Keywords
- Doppler sonography
- Fetoscopy
- Laser coagulation
- Monochorionic twins
- Nd:YAG laser
- Placental vessel
- Twin-twin transfusion syndrome
ASJC Scopus subject areas
- Obstetrics and Gynecology
- Pediatrics, Perinatology, and Child Health
Cite this
Twin-twin transfusion syndrome : The 'select' procedure. / Feldstein, Vickie A.; Machin, Geoffrey A.; Albanese, Craig T.; Sandberg, Per; Farrell, Jody A.; Farmer, Diana L; Harrison, Michael R.
In: Fetal Diagnosis and Therapy, Vol. 15, No. 5, 09.2000, p. 257-261.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Twin-twin transfusion syndrome
T2 - The 'select' procedure
AU - Feldstein, Vickie A.
AU - Machin, Geoffrey A.
AU - Albanese, Craig T.
AU - Sandberg, Per
AU - Farrell, Jody A.
AU - Farmer, Diana L
AU - Harrison, Michael R.
PY - 2000/9
Y1 - 2000/9
N2 - Objectives: Twin-twin transfusion syndrome (TTTS) is associated with a high risk of perinatal morbidity and mortality. The condition results from intertwin vascular connections in the shared placenta. We report here a case of early, severe TTTS that failed to respond to serial amniocenteses and that was successfully treated by means of superselective laser coagulation. Methods: A causative arteriovenous anastomosis was identified by means of prenatal obstetrical sonography, using color and spectral Doppler techniques. At fetoscopy, performed at 23 weeks' gestation, laser occlusion of only this connection was achieved. Results: This therapeutic intervention resulted in rapid resolution of all evidence of TTTS and a successful pregnancy outcome, with subsequent delivery of 2 healthy infants at 33 weeks' gestation. Conclusions: The potentially fatal pathophysiology of TTTS was reversed by interruption of a single arteriovenous connection. We have termed this the sonographically evaluated, laser-endoscopic coagulation for twins ('Select') procedure. Copyright (C) 2000 S. Karger AG, Basel.
AB - Objectives: Twin-twin transfusion syndrome (TTTS) is associated with a high risk of perinatal morbidity and mortality. The condition results from intertwin vascular connections in the shared placenta. We report here a case of early, severe TTTS that failed to respond to serial amniocenteses and that was successfully treated by means of superselective laser coagulation. Methods: A causative arteriovenous anastomosis was identified by means of prenatal obstetrical sonography, using color and spectral Doppler techniques. At fetoscopy, performed at 23 weeks' gestation, laser occlusion of only this connection was achieved. Results: This therapeutic intervention resulted in rapid resolution of all evidence of TTTS and a successful pregnancy outcome, with subsequent delivery of 2 healthy infants at 33 weeks' gestation. Conclusions: The potentially fatal pathophysiology of TTTS was reversed by interruption of a single arteriovenous connection. We have termed this the sonographically evaluated, laser-endoscopic coagulation for twins ('Select') procedure. Copyright (C) 2000 S. Karger AG, Basel.
KW - Doppler sonography
KW - Fetoscopy
KW - Laser coagulation
KW - Monochorionic twins
KW - Nd:YAG laser
KW - Placental vessel
KW - Twin-twin transfusion syndrome
UR - http://www.scopus.com/inward/record.url?scp=0033813756&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033813756&partnerID=8YFLogxK
M3 - Article
C2 - 10971077
AN - SCOPUS:0033813756
VL - 15
SP - 257
EP - 261
JO - Fetal Diagnosis and Therapy
JF - Fetal Diagnosis and Therapy
SN - 1015-3837
IS - 5
ER -