Stuck Twin with Cotwin Nonimmune Hydrops: Successful Treatment by Amniocentesis
作者:
Joseph R. Wax,
Karin J. Blakemore,
Patrick Blohm,
Nancy A. Callan,
期刊:
Fetal Diagnosis and Therapy
(Karger Available online 1991)
卷期:
Volume 6,
issue 3-4
页码: 126-131
ISSN:1015-3837
年代: 1991
DOI:10.1159/000263636
出版商: S. Karger AG
关键词: Stuck twin;Amniocentesis;Twin transfusion syndrome
数据来源: Karger
摘要:
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 tracin
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