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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