Twin-twin transfusion syndrome: The 'select' procedure

Vickie A. Feldstein, Geoffrey A. Machin, Craig T. Albanese, Per Sandberg, Jody A. Farrell, Diana L Farmer, Michael R. Harrison

Research output: Contribution to journalArticle

40 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)257-261
Number of pages5
JournalFetal Diagnosis and Therapy
Volume15
Issue number5
StatePublished - Sep 2000

Fingerprint

Fetofetal Transfusion
Laser Coagulation
Fetoscopy
Prenatal Ultrasonography
Arteriovenous Anastomosis
Pregnancy
Amniocentesis
Perinatal Mortality
Pregnancy Outcome
Placenta
Blood Vessels
Lasers
Color
Morbidity

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

Feldstein, V. A., Machin, G. A., Albanese, C. T., Sandberg, P., Farrell, J. A., Farmer, D. L., & Harrison, M. R. (2000). Twin-twin transfusion syndrome: The 'select' procedure. Fetal Diagnosis and Therapy, 15(5), 257-261.

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 journalArticle

Feldstein, VA, Machin, GA, Albanese, CT, Sandberg, P, Farrell, JA, Farmer, DL & Harrison, MR 2000, 'Twin-twin transfusion syndrome: The 'select' procedure', Fetal Diagnosis and Therapy, vol. 15, no. 5, pp. 257-261.
Feldstein VA, Machin GA, Albanese CT, Sandberg P, Farrell JA, Farmer DL et al. Twin-twin transfusion syndrome: The 'select' procedure. Fetal Diagnosis and Therapy. 2000 Sep;15(5):257-261.
Feldstein, Vickie A. ; Machin, Geoffrey A. ; Albanese, Craig T. ; Sandberg, Per ; Farrell, Jody A. ; Farmer, Diana L ; Harrison, Michael R. / Twin-twin transfusion syndrome : The 'select' procedure. In: Fetal Diagnosis and Therapy. 2000 ; Vol. 15, No. 5. pp. 257-261.
@article{c2d0dbc0b78e4091b7f1be1f05bcb1f6,
title = "Twin-twin transfusion syndrome: The 'select' procedure",
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.",
keywords = "Doppler sonography, Fetoscopy, Laser coagulation, Monochorionic twins, Nd:YAG laser, Placental vessel, Twin-twin transfusion syndrome",
author = "Feldstein, {Vickie A.} and Machin, {Geoffrey A.} and Albanese, {Craig T.} and Per Sandberg and Farrell, {Jody A.} and Farmer, {Diana L} and Harrison, {Michael R.}",
year = "2000",
month = "9",
language = "English (US)",
volume = "15",
pages = "257--261",
journal = "Fetal Diagnosis and Therapy",
issn = "1015-3837",
publisher = "S. Karger AG",
number = "5",

}

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 -