Intrauterine assessment of high-output cardiac failure with spontaneous remission of hydrops fetalis in twin–twin transfusion syndrome: Use of two-dimensional echocardiography, doppler ultrasound, and color flow mapping
✍ Scribed by R. Achiron; R. Rabinovitz; Y. Aboulafia; Y. Diamant; J. Glaser
- Publisher
- John Wiley and Sons
- Year
- 1992
- Tongue
- English
- Weight
- 688 KB
- Volume
- 20
- Category
- Article
- ISSN
- 0091-2751
No coin nor oath required. For personal study only.
✦ Synopsis
Twin-twin transfusion syndrome (TTTS) is a severe in utero complication of monozygotic twin pregnancies. It occurs as a result of blood transfer through anastomotic vessel in the placenta.' Both acute and chronic forms of TTTS have been clinically described. In the acute form, a significant amount of blood is transferred through anastomotic vessels during labor or delivery, resulting in a hypovolemic-anemic donor twin, and a hypervolemic-plethoric recipient twin both of similar birth eight.^,^ In the chronic syndrome, gradual transfer of blood occurs early in pregnancy so that the donor twin becomes hypovolemic and anemic, as well as growth retarded and oligohydramnic. The recipient twin may become hypervolemic and polycythemic, and hydrops fetalis with hydramnios may d e ~e l o p . ~, ~ The TTTS has a dynamic complex pathophysi-010gy,~ which carries a high perinatal mortality, up to 70%.7 In view of the poor outcome of this condition, aggressive therapeutic procedures, such as selective feticide,8 placental vessel punctures,' and multiple amniocentesis" have been proposed. Because spontaneous remission of the hydrops in TTTS has been described," alternative conservative management deserves consideration. The purpose of this communication is to describe a case of in utero spontaneous resolu-From the