VP29.11: TAPS case in monochorionic twins with prenatal polycythemia prevalence

AbstractObjectivesTo evaluate the impact of placental anastomoses on the intrauterine growth of monochorionic (MC) twins.MethodsA prospective study was conducted in a group of 53 MC twins. Intrapartally umbilical cords were clamped to identify placental sides corresponding to each twin. The postnatal dye injection technique was administered to evaluate vascular anastomoses, their number and type and visualize placental territory sharing patterns. Data from digital analysis were correlated with obstetrical follow-up.ResultsVascular anastomoses were revealed in 88.7% of cases. Arteriovenous (AV) anastomoses occurred in 75.4% and arterioarterial (AA) in 71.1% while venovenous (VV) in 26.4%. In the subgroup of MC twins without placental anastomoses, significantly higher birthweight difference and discordance were revealed when compared to MC twins without anastomoses (382.0 vs. 22 g; P = 0.03 and 49.14% vs. 16.02%; P = 0.03). On the other hand, in subgroups of MC twins with at least one AA anastomosis, twins’ birthweights were similar (p = ns) despite significantly higher placental territory sharing discordance (30.44% vs. 15.81%; P = 0.31).ConclusionsVascular anastomoses have a major impact on the intrauterine growth of MC twins. In certain cases, they may cause specific complications; however, in general, they regulate intertwin blood exchange and may compensate unequal placental territory.

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Ricerche immunoelettroforetiche sul sangue funicolare nei gemelli

Acta geneticae medicae et gemellologiae ◽

10.1017/s1120962300020308 ◽

1962 ◽

Vol 11 (2) ◽

pp. 130-137

Author(s):

G. Abelli ◽

A. Esposito

Keyword(s):

Protein Composition ◽

Monochorionic Twins ◽

Electrophoretic Method

SUMMARYThe Authors have investigated by means of the immuno-electrophoretic method the protein composition of the funicular blood of 19 twin-pairs from pregnancies of 5 to 9 months. Monochorionic twins showed a concordant picture, while in 7 of the 14 bichorionic twin-pairs slight differences could be observed, due to the presence in one of the twins of one or two more lines. The Authors put these results in correlation with the hypothesis of a genie control of the production of proteins.

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Fetal cardiac output in monochorionic twins

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.6230 ◽

2008 ◽

Vol 32 (6) ◽

pp. 807-812 ◽

Cited By ~ 4

Author(s):

M. Sueters ◽

J. M. Middeldorp ◽

E. Lopriore ◽

R. Bökenkamp ◽

D. Oepkes ◽

...

Keyword(s):

Cardiac Output ◽

Monochorionic Twins

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DIAGNOSIS AND MANAGEMENT OF SELECTIVE FETAL GROWTH RESTRICTION IN MONOCHORIONIC TWINS

Fetal and Maternal Medicine Review ◽

10.1017/s0965539509990106 ◽

2009 ◽

Vol 20 (4) ◽

pp. 269-281 ◽

Cited By ~ 1

Author(s):

EDUARD GRATACÓS ◽

ELISENDA EIXARCH ◽

FATIMA CRISPI

Keyword(s):

Fetal Growth ◽

Common Sense ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Fetal Weight ◽

Abdominal Circumference ◽

Monochorionic Twins ◽

Normal Ranges ◽

Estimated Fetal Weight ◽

Simple Definition

Selective fetal growth restriction (sFGR) has been reported to occur in about 10–15% of monochorionic (MC) twins. The diagnosis of sFGR has been based on variable criteria including estimated fetal weight (EFW), abdominal circumference and/or the degree of fetal weight discordance. Recent studies tend to use a simple definition which includes the presence of an EFW less than the 10th percentile in the smaller twin. Some would argue that the intertwin fetal weight discordance should be included in the definition. Indeed this factor plays a major role in the complications presented by these cases. While the majority of cases with one fetus below the 10th percentile usually will also present with a large intertwin EFW discordance, the contrary is not always true. Thus, it is possible to find MC twins with remarkable intertwin EFW discordance but the EFW of both fetuses are still within normal ranges. Although it appears to be common sense that a large intertwin discrepancy might represent a higher risk for some of the complications described later in this review, there is no consistent evidence to support this notion. Therefore, due to its simplicity, a definition based on an EFW below 10th percentile in one twin is probably the most useful for clinical and research purposes.

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