scholarly journals P21.01: Is there an optimal gestational age for delivery following fetoscopic laser coagulation of chorionic plate?

2011 ◽  
Vol 38 (S1) ◽  
pp. 236-237
Author(s):  
T. Quibel ◽  
J. Stirnemann ◽  
A. Al-Ibrahim ◽  
M. Essaoui ◽  
Y. Ville
2018 ◽  
Vol 5 (3) ◽  
pp. 66-69
Author(s):  
A. V. Mikhailov ◽  
A. N. Romanovsky ◽  
P. A. Ovsyannikov ◽  
T. A. Kashtanova ◽  
I. V. Kyanksep ◽  
...  

Recurrence of twin-to-twin transfusion syndrome (TTTS) after fetoscopic laser coagulation (FLC) of placental anastomoses is unfavorable complication. Multiparous woman 34 years old in TTTS stage 2 was performed FLC of 8 arteriovenous anastomoses of the placenta followed by amnioreduction of 1000 ml on the gestational age of 22 weeks and 2 days. At gestational age of 24 weeks 6 days was revealed a recurrence of the TTTS, with considerable polyhydramnion of recipient and anhydramnion of the donor, a repeated FLC of 5 residual placental anastomoses was performed and amnioreduction of 2000 ml at 25 weeks 1 day of gestation. On the fifth day was normalized the amount of amniotic fluid of both fetuses. At 32 weeks of gestation spontaneously was began the birth, the weights of newborns were 1560 and 1600 g, both had Apgar score 8/9. Respiratory therapy continued for 7 hours at the second newborn and for 13 hours at the first newborn girl after transferring to the ICU. The signs of the respiratory failure were not observed. There were no differences between complete blood counts. This clinical case confirms the possibility of effective correction of recurrence TTTS with the help of repeated FLC of placental anastomoses.


2002 ◽  
Vol 5 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Monique E. De Paepe ◽  
Sarah Burke ◽  
Francois I. Luks ◽  
Halit Pinar ◽  
Don B. Singer

Invasive treatment modalities for severe chronic twin-to-twin transfusion syndrome (TTTS), such as fetoscopic laser coagulation of communicating vessels, have revived the need for detailed studies of placental angioar-chitecture. We describe a practical placental vascular injection technique using alcohol-resistant tissue-staining dyes. Injection of color-coded gelatin-dye mixtures effectively delineated the intertwin vasculature, and allowed unequivocal macroscopic classification of vascular communications as artery-to-artery, vein-to-vein, or deep artery–to-vein anastomoses. The existence of deep artery–to-vein anastomoses was further confirmed by light microscopic demonstration of venous dye of one twin and arterial dye of the opposite twin within the same stem villus. Furthermore, the injection technique allowed determination of the caliber of the anastomoses, the direction of the artery-to-vein anastomoses, and the relative vascular territory of each twin. Documenting the vascular communications in monochorionic twin placentas with and without TTTS may enhance our understanding of the pathogenesis of chronic TTTS. Correlating the anastomotic patterns and location of the laser coagulation scars with post-ablation outcome will aid in the design of rational therapeutic methods for this often lethal condition.


2004 ◽  
Vol 191 (6) ◽  
pp. S131
Author(s):  
Ilinca Gussi ◽  
Jacky Nizard ◽  
Lydia Malagrida ◽  
Massami Yamamoto ◽  
Romaine Robyr ◽  
...  

2017 ◽  
Vol 50 (6) ◽  
pp. 728-735 ◽  
Author(s):  
W. Diehl ◽  
A. Diemert ◽  
D. Grasso ◽  
S. Sehner ◽  
K. Wegscheider ◽  
...  

2005 ◽  
Vol 46 (3) ◽  
pp. 328-330 ◽  
Author(s):  
T. A. G. M. Huisman ◽  
L. Lewi ◽  
R. Zimmermann ◽  
U. V. Willi ◽  
J. Deprest

Twin‐to‐twin transfusion syndrome (TTTS) is a severe complication in monochorionic twin pregnancies that results from a hemodynamical imbalance of placentar vascular anstomoses that connect the circulation of both fetuses. In TTTS, a poly/oligohydramnios sequence with high fetal morbidity and mortality rates occurs. Fetoscopic laser coagulation of the placentar anastomoses can limit or prevent fetal injury. The purpose of this report is to present and discuss fetal magnetic resonance imaging as a postoperative imaging tool after fetoscopic laser coagulation.


2013 ◽  
Vol 4 (3) ◽  
pp. 249-255 ◽  
Author(s):  
J. Armstrong-Wells ◽  
M. D. Post ◽  
M. Donnelly ◽  
M. J. Manco-Johnson ◽  
B. M. Fisher ◽  
...  

Inflammation is associated with preterm premature rupture of membranes (PPROM) and adverse neonatal outcomes. Subchorionic thrombi, with or without inflammation, may also be a significant pathological finding in PPROM. Patterns of inflammation and thrombosis may give insight into mechanisms of adverse neonatal outcomes associated with PPROM. To characterize histologic findings of placentas from pregnancies complicated by PPROM at altitude, 44 placentas were evaluated for gross and histological indicators of inflammation and thrombosis. Student's t-test (or Mann–Whitney U-test), χ2 analysis (or Fisher's exact test), mean square contingency and logistic regression were used when appropriate. The prevalence of histologic acute chorioamnionitis (HCA) was 59%. Fetal-derived inflammation (funisitis and chorionic plate vasculitis) was seen at lower frequency (30% and 45%, respectively) and not always in association with HCA. There was a trend for Hispanic women to have higher odds of funisitis (OR = 5.9; P = 0.05). Subchorionic thrombi were seen in 34% of all placentas. The odds of subchorionic thrombi without HCA was 6.3 times greater that the odds of subchorionic thrombi with HCA (P = 0.02). There was no difference in gestational age or rupture-to-delivery interval, with the presence or absence of inflammatory or thrombotic lesions. These findings suggest that PPROM is caused by or can result in fetal inflammation, placental malperfusion, or both, independent of gestational age or rupture-to-delivery interval; maternal ethnicity and altitude may contribute to these findings. Future studies focused on this constellation of PPROM placental findings, genetic polymorphisms and neonatal outcomes are needed.


2015 ◽  
Vol 54 (5) ◽  
pp. 580-582 ◽  
Author(s):  
Yao-Lung Chang ◽  
Tzu-Hao Wang ◽  
Shuenn-Dyh Chang ◽  
An-Shine Chao ◽  
Peter C.C. Hsieh

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