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Residual anastomoses in twin-to-twin transfusion syndrome treated with selective fetoscopic laser surgery: localization, size, and consequences.
- Source :
-
American journal of obstetrics and gynecology [Am J Obstet Gynecol] 2009 Jul; Vol. 201 (1), pp. 66.e1-4. - Publication Year :
- 2009
-
Abstract
- Objective: To study the localization and size of residual anastomoses in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery and correlate the findings with outcome.<br />Study Design: Placental injection in twin-to-twin transfusion syndrome placentas treated with laser was performed by using colored dye.<br />Results: A total of 77 twin-to-twin transfusion syndrome placentas were included in the study. Residual anastomoses (n = 48) were found in 32% (25/77) of lasered placentas. Most residual anastomoses were localized near the margin of the placenta. The majority of residual anastomoses (67%; 32/48) were very small (diameter, < 1 mm). Eleven of the 25 cases (44%) in the residual anastomoses group developed twin anemia-polycythemia sequence.<br />Conclusion: Most residual anastomoses in twin-to-twin transfusion syndrome placentas treated with laser are very small and localized near the placental margin. Almost half of cases with residual anastomoses developed twin anemia-polycythemia sequence after laser surgery.
- Subjects :
- Adult
Anemia pathology
Female
Fetal Diseases pathology
Fetofetal Transfusion pathology
Humans
Laser Coagulation
Placenta surgery
Polycythemia pathology
Pregnancy
Twins, Monozygotic blood
Arteriovenous Anastomosis surgery
Fetofetal Transfusion surgery
Fetoscopy
Fetus blood supply
Fetus surgery
Placenta blood supply
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6868
- Volume :
- 201
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- American journal of obstetrics and gynecology
- Publication Type :
- Academic Journal
- Accession number :
- 19306965
- Full Text :
- https://doi.org/10.1016/j.ajog.2009.01.010