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Twin-to-Twin Transfusion Syndrome: Selective Feticide by Embolization of the Hydropic Fetus

 

作者: Marc Dommergues,   Laurent Mandelbrot,   Anne-Lyse Delezoide,   Marie-Cécile Aubry,   Laurent Fermont,   Dominique Caputo-Mahieu,   Yves Dumez,  

 

期刊: Fetal Diagnosis and Therapy  (Karger Available online 1995)
卷期: Volume 10, issue 1  

页码: 26-31

 

ISSN:1015-3837

 

年代: 1995

 

DOI:10.1159/000264188

 

出版商: S. Karger AG

 

关键词: Selective feticide;Embolization;Twin-to-twin transfusion syndrome

 

数据来源: Karger

 

摘要:

To improve the outcome of severe twin-to-twin transfusion syndrome with 1 hydropic fetus and to prevent ischemic sequelae in the survivor, we developed a technique of selective feticide by vascular embolization of the most severely damaged twin. Acute second trimester polyhydramnios occurred in 4 biamniotic monochorial twin pregnancies, with 1 fetus normal on ultrasound but the other severely damaged by hydrops and hypertrophic hypokinetic cardiomyopathy. The hydropic fetus underwent embolization using a bolus of histoacryl injected into the umbilical vein and fetal heart under ultrasound guidance. In 1 triplet pregnancy with a set of monochorial fetuses, premature labor occurred at 26 weeks, 2 weeks after embolization, and there were 2 neonatal deaths. The 3 other cases resulted in the birth of a normal infant at 31–37 weeks of gestation. This suggests that in twin-to-twin transfusion syndrome with severe polyhydramnios and hydrops of 1 fetus, embolization may salvage the other twi

 

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