scholarly journals Experience of repeated fetoscopic laser coagulation of placental anastomoses in case of recurrence of twin-to-twin transfusion syndrome

2018 ◽  
Vol 5 (3) ◽  
pp. 66-69
Author(s):  
A. V. Mikhailov ◽  
A. N. Romanovsky ◽  
P. A. Ovsyannikov ◽  
T. A. Kashtanova ◽  
I. V. Kyanksep ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Clinical Case ◽  
Laser Coagulation ◽  
Multiparous Woman ◽  
Arteriovenous Anastomoses ◽  
Newborn Girl ◽  
Fetoscopic Laser Coagulation ◽  
Complete Blood Counts

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.

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
Keyword(s):  
Gestational Age ◽  
Laser Coagulation ◽  
Chorionic Plate ◽  
Fetoscopic Laser Coagulation

Sonographic Assessment of Amniotic Fluid Volume using Single Deepest Pocket (SDP) among Igbo Women with Uncomplicated Singleton Pregnancies.

2019 ◽  
Vol 2 (1) ◽  
pp. 1-18
Author(s):  
Chijioke Okeudo ◽  
B.U. Ezem
Keyword(s):  
Amniotic Fluid ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Fluid Volume ◽  
Singleton Pregnancy ◽  
Cross Sectional ◽  
South Eastern ◽  
Amniotic Fluid Volume ◽  
The Mean ◽  
Singleton Pregnancies

Background: The amniotic fluid is fundamental for proper fetal development and growth. Ultrasound visualization of the amniotic fluid permits both subjective and objective estimates of the amniotic fluid. Objective: The objective of this study was to determine the reference values of normal single deepest pocket (SDP) – upper and lower limits, mean SDP and variation of the SDP with gestational age among Igbo women of South-Eastern Nigeria extraction carrying uncomplicated singleton pregnancy. Methodology: This was a prospective cross sectional study involving 400 women carrying uncomplicated singleton pregnancies and who were sure of the date of the first day of their last menstrual period. The single deepest pocket / maximum vertical pool were determined once at presentation at the hospital.. The study was conducted from January 1st to December 31st 2015. The second author carried out all the scanning. The SDP was obtained. Results: The womens’ mean and median ages were the same at 28 years. The gestational age range of the pregnancies was 14-41 weeks. The mean SDP was 5.8cm, while the 5th and 95th percentiles were 3.3cm and 8.5cm respectively. There was no difference in the mean SDP in both term and preterm. There was irregular but continuous rise of mean SDP to a peak of 6.8cm at gestational age of 39 weeks. In conclusion, the participants had a mean SDP of 5.8cm. There was also a positive correlation between SDP and Gestational age. We therefore recommend a longitudinal study to assess perinatal outcome and abnormal amniotic fluid volume among Igbo women of South-Eastern Nigeria. Key words: Single Deepest Pocket, Uncomplicated Singleton Pregnancy, Igbo Women.

Demonstration of Placental Vascular Anatomy in Monochorionic Twin Gestations

2002 ◽  
Vol 5 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Monique E. De Paepe ◽  
Sarah Burke ◽  
Francois I. Luks ◽  
Halit Pinar ◽  
Don B. Singer
Keyword(s):  
Vascular Anatomy ◽  
Treatment Modalities ◽  
Laser Coagulation ◽  
Injection Technique ◽  
Invasive Treatment ◽  
Monochorionic Twin ◽  
Macroscopic Classification ◽  
Fetoscopic Laser Coagulation

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.

Laser Ablation of Posterior Urethral Valves by Fetal Cystoscopy

2015 ◽  
Vol 37 (4) ◽  
pp. 267-273 ◽  
Author(s):  
José María Martínez ◽  
Narcis Masoller ◽  
Roland Devlieger ◽  
Esther Passchyn ◽  
Olga Gómez ◽  
...  
Keyword(s):  
Renal Failure ◽  
Laser Ablation ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Significant Risk ◽  
Operation Time ◽  
Posterior Urethral Valves ◽  
Consecutive Series ◽  
Urethral Valves ◽  
Median Operation Time

Objective: To report the results of fetal cystoscopic laser ablation of posterior urethral valves (PUV) in a consecutive series in two referral centers. Methods: Twenty pregnant women with a presumptive isolated PUV were treated with fetal cystoscopy under local anesthesia. Identification and fulguration of the PUV by one or several firing-contacts with diode laser were attempted. Perinatal and long-term outcomes were prospectively recorded. Results: The median gestational age at procedure was 18.1 weeks (range 15.0-25.6), and median operation time was 24 min (range 15-40). Access to the urethra was achieved in 19/20 (95%) cases, and postoperative, normalization of bladder size and amniotic fluid was observed in 16/20 (80%). Overall, there were 9 (45%) terminations of pregnancy and 11 women (55%) delivered a liveborn baby at a mean gestational age of 37.3 (29.1-40.2) weeks. No infants developed pulmonary hypoplasia and all were alive at 15-110 months. Eight (40% of all fetuses, 72.7% of newborns) had normal renal function and 3 (27.3%) had renal failure awaiting renal transplantation. Conclusion: Fetoscopic laser ablation for PUV can achieve bladder decompression and amniotic fluid normalization with a single procedure in selected cases with anyhydramnios. There is still a significant risk of progression to renal failure pre or postnatally.

CAUTION IN INTERPRETATION OF AMNIOTIC FLUID INDICES OF FETAL PULMONARY MATURITY

PEDIATRICS ◽  
1989 ◽  
Vol 84 (2) ◽  
pp. A24-A24
Author(s):  
Student
Keyword(s):  
Amniotic Fluid ◽  
Gestational Age ◽  
Caesarian Section ◽  
Misleading Information

When gestational age has been firmly established by standard obstetric criteria, the risks of routine amniocentesis prior to repeat caesarian section in the uncomplicated term gestation [to obtain amniotic fluid indices of fetal pulmonary maturity] outweigh the usefulness of the potentially uninformative or misleading information gained.

scholarly journals Fetoscopic laser coagulation in 1020 pregnancies with twin-twin transfusion syndrome demonstrates improvement in double-twin survival rate

2017 ◽  
Vol 50 (6) ◽  
pp. 728-735 ◽  
Author(s):  
W. Diehl ◽  
A. Diemert ◽  
D. Grasso ◽  
S. Sehner ◽  
K. Wegscheider ◽  
...  
Keyword(s):  
Survival Rate ◽  
Laser Coagulation ◽  
Fetoscopic Laser Coagulation ◽  
Double Twin

scholarly journals Frequency of Caesarean Section in Pregnancies with Borderline Amniotic Fluid Index at Term

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Natasha Bushra ◽  
Khaula Zeeshan ◽  
Sara Ejaz ◽  
Javeria Mushtaq ◽  
Khadija Waheed ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Induction Of Labour ◽  
Amniotic Fluid Index ◽  
Cross Sectional ◽  
Increased Risk ◽  
Failed Induction ◽  
One Year

AbstractThe increased risk of caesarean section after induced labour is well documented. Rate of induction of labour has doubled in the past decade from 10 to 20%. Low Amniotic Fluid Index (AFI) as an isolated finding leads to increased obstetrical interventions but without any improvement in outcome.Objectives:  To determine the frequency of caesarean section due to failed induction in pregnancies at term with borderline AFI.Patients and Methods:  This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Unit-III, SIMS/Services Hospital, Lahore. The duration of study was one year from January, 2015 to December, 2015. A total of 150 patients were included in this study. AFI was measured by recent obstetric ultrasound. All patients with borderline AFI (5 – 8 cm) were included in the study. They were induced by glandin E2 gel. If induction of patients failed with two doses of glandin E2 gel, given vaginally 6 hours apart, patients were considered for cesarean section. The outcome measure was rate of caesarean section due to failed induction. All data were analyzed by SPSS version 20.Results:  Mean age of the patients was 30.34 ± 6.68 years. Mean gestational age was noted 38.34 ± 1.05 weeks. Out of 150 patients, 103 (68.7%) were para 1 – 3 and 47 patients (31.3%) were para 4 – 6. Caesarean section due to failed induction with borderline AFI was performed in 27 patients (18.0%). Stratification with regard to age, gestational age and parity was carried out and was found significant only for gestational age being > 39 weeks.Conclusion:  It is concluded that failed induction of labour at term in women with borderline AFI is not associated with increased risk of caesarean delivery.

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