228: Monochorionic twins with Selective Intrauterine Growth Restriction (SIUGR) type II: Laser surgery versus cord occlusion

2019 ◽  
Vol 220 (1) ◽  
pp. S165
Author(s):  
Ramen H. Chmait ◽  
Andrew H. Chon ◽  
Lisa M. Korst ◽  
Stephen Ma ◽  
Arlyn Llanes ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Laser Surgery ◽  
Growth Restriction ◽  
Type Ii ◽  
Monochorionic Twins ◽  
Intrauterine Growth

Cord Occlusion in Monochorionic Twins with Early Selective Intrauterine Growth Restriction and Abnormal Umbilical Artery Doppler: A Consecutive Series of 90 Cases

2015 ◽  
Vol 39 (3) ◽  
pp. 186-191 ◽  
Author(s):  
Mauro Parra-Cordero ◽  
Mar Bennasar ◽  
José María Martínez ◽  
Elisenda Eixarch ◽  
Ximena Torres ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Consecutive Series ◽  
Type Ii ◽  
Monochorionic Twins ◽  
Intrauterine Growth ◽  
Umbilical Artery Doppler

Objective: To describe perinatal outcomes achieved with cord occlusion (CO) in monochorionic twins with severe selective intrauterine growth restriction (sIUGR) and abnormal umbilical artery Doppler in the IUGR twin (types II and III). Methods: We studied a consecutive series of 90 cases of sIUGR with abnormal Doppler treated with CO of the IUGR fetus. Abnormal Doppler was defined as continuous (type II, n = 41) or intermittent (type III, n = 49) absent/reversed end-diastolic flow. All cases presented at least one of the following severity criteria: gestational age (GA) <22 weeks, inter-twin estimated weight discordance >35%, reversed end-diastolic umbilical artery flow or ductus venosus pulsatility index >95th centile. We prospectively recorded pregnancy course and perinatal outcome. Results: Median GA at surgery was 20.6 weeks and mean duration 22.4 min. Miscarriage (<24 weeks) occurred in 3.3% (3/90) and preterm delivery <32 weeks in 7.1% (6/84) of continuing pregnancies. GA at delivery was 36.4 weeks and neonatal survival of the larger twin was achieved in 93.3%. Conclusion: In a consecutive series studied by an experienced team, CO in monochorionic twins with severe sIUGR type II or III was associated with delivery >32 weeks in 92.9% and neonatal survival of the normal twin in 93.3% of pregnancies.

Expectant management in type II selective intrauterine growth restriction and abnormal chord insertion in monochorionic twins

2013 ◽  
Vol 41 (3) ◽  
Author(s):  
Silvia Visentin ◽  
Veronica Macchi ◽  
Francesca Grumolato ◽  
Andrea Porzionato ◽  
Raffaele De Caro ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Expectant Management ◽  
Growth Restriction ◽  
Type Ii ◽  
Monochorionic Twins ◽  
Intrauterine Growth

Decreased Total Placental Mass Found in Twin-Twin Transfusion Syndrome Gestations with Selective Growth Restriction

2016 ◽  
Vol 40 (2) ◽  
pp. 116-122 ◽  
Author(s):  
Kristi R. Van Winden ◽  
Rubén A. Quintero ◽  
Eftichia V. Kontopoulos ◽  
Lisa M. Korst ◽  
Arlyn Llanes ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Laser Surgery ◽  
Growth Restriction ◽  
Placental Weight ◽  
Apparent Difference ◽  
Inclusion Criteria ◽  
Fetal Demise ◽  
Intrauterine Growth ◽  
Share Data ◽  
The Individual

Introduction: We examined placental weight characteristics associated with donor selective intrauterine growth restriction (SIUGR) among patients with twin-twin transfusion syndrome (TTTS) who underwent laser surgery. Materials and Methods: Fresh placental specimens were studied. Pregnancies with higher-order multiples, fetal demise, or disrupted or nonsubmitted placental specimens were excluded. Placental characteristics prospectively collected included total placental weight, individual placental weight, and placental share. Data were compared between pregnancies with SIUGR (TTTS + SIUGR group) and those without SIUGR (TTTS-only group). Results: Of 369 consecutive patients who underwent laser surgery for TTTS, 155 (42%) met inclusion criteria: 91 with TTTS + SIUGR and 64 with TTTS-only. Compared to the TTTS-only group, patients in the TTTS + SIUGR group had a lower total placental weight (608 ± 163 vs. 687 ± 224 g, p = 0.012), with a lower donor individual placental weight (237 ± 91 vs. 291 ± 124 g, p = 0.002), but no apparent difference in the individual placental weight of recipient twins (371 ± 109 vs. 396 ± 133 g, p = 0.211). Donor placental share was smaller in those pregnancies affected by SIUGR (38.7 ± 9.6 vs. 42.3 ± 9.8%, p = 0.029). Discussion: TTTS patients with SIUGR had a lower total placental weight and a lower donor individual placental weight compared to those without SIUGR. These findings suggest that differences in donor individual placental weights for SIUGR gestations may not solely be related to differences in placental share.

Is computerized cardiotocography useful in monochorionic twins with selective intrauterine growth restriction?

2020 ◽  
pp. 1-6
Author(s):  
Anouk Bertrang Warncke ◽  
Sibylle Zbären ◽  
Daniele Bolla ◽  
Marc Baumann ◽  
Beatrice Mosimann ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Growth Restriction ◽  
Monochorionic Twins ◽  
Intrauterine Growth

scholarly journals Right Ventricular Outflow Tract Obstruction in Monochorionic Twins with Selective Intrauterine Growth Restriction

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
S. B. de Haseth ◽  
M. C. Haak ◽  
A. A. W. Roest ◽  
M. E. B. Rijlaarsdam ◽  
D. Oepkes ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Intrauterine Growth Restriction ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Growth Restriction ◽  
Monochorionic Twins ◽  
Monochorionic Twin ◽  
Intrauterine Growth ◽  
Ventricular Outflow Tract Obstruction

Monochorionic twin pregnancies are at increased risk of perinatal mortality and morbidity due to twin-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR), and higher incidence of congenital heart malformations. The incidence of right ventricular outflow tract obstruction (RVOTO) in recipients with TTTS is known to be higher than in the general population. There is limited data on the risk of RVOTO in monochorionic twins with sIUGR. We report a case of RVOTO in the larger twin in a monochorionic twin pregnancy with sIUGR, treated successfully with balloon dilatation after birth.

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