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Twin-to-twin transfusion syndrome: a case report. Antepartum prediction of underlying placental vascular pattern in monochorionic twin pregnancies may be possible

Published online by Cambridge University Press:  21 February 2012

Hans A Zondervan
Affiliation:
Department of Obstetrics and Gynecology, Hospital Rynstate, Arnhem, The Netherlands. hzondervan@compuserve.com
Martin JC van Gemert
Affiliation:
Laser Center, Academic Medical Center, University of Amsterdam, The Netherlands.
Peter JG Nikkels
Affiliation:
Department of Pathology, Academic Hospital, University of Utrecht, The Netherlands.
Annemieke Omtzigt
Affiliation:
Department of Obstetrics and Gynecology, Flevo Hospital, Almere, The Netherlands.
Martin Offringa
Affiliation:
Department of Neonatology, Emma’s Hospital, Academic Medical Center, University of Amsterdam, The Netherlands.
Jan Deprest
Affiliation:
Department of Obstetrics and Gynecology, Catholic University, Leuven, Belgium.
Otto P Bleker
Affiliation:
Department of Obstetrics and Gynecology, Hospital Rynstate, Arnhem, The Netherlands.
Corresponding
E-mail address:

Abstract

A case of twin-to-twin transfusion syndrome is described. Comparing data of serial antepartum ultrasonography with a haemodynamic model suggests the possibility of predicting the underlying placental vascular anatomy. It is suggested that serial ultrasonography, including full biometry, pulsatility indices of the umbilical arteries, foetal echocardiography, assessment of amniotic fluid indices and foetal bladder filling could serve as ultrasound parameters for pattern recognition of the underlying placental vascular anomaly. Biometry should be plotted serially in a difference/ average plot. Future application of such intensive ultrasound monitoring in monochorionic twins, as soon as monochorionicity is established, may distinguish those monochorionic twins who may benefit from treatment from those whom it would be better only to observe.

Type
Short Report
Copyright
Copyright © Cambridge University Press 1999
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Twin-to-twin transfusion syndrome: a case report. Antepartum prediction of underlying placental vascular pattern in monochorionic twin pregnancies may be possible
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