The Twin Of Twin Transfusion Syndrome ( Ttts )

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INTRODUCTION: Twin-to-twin transfusion syndrome (TTTS) is a rare disease occurring in 10-15% of monochorionic-diamniotic twin gestations in which vascular connections are shared between the fetuses via a common placenta1, 2, 3. A theoretical imbalance in the vascular distribution creates a shift in circulation causing one fetus to receive a surplus in volume, the recipient, and the other to be deficient, the donor4, 5. TTTS can present at any gestational age6 and can progress in severity causing significant morbidity, especially to the recipient, and even demise of one or both twins1, 2, 6. Classic ultrasonic markers of TTTS have been well-described as an amniotic fluid imbalance between the twins2. Several staging systems have been…show more content…
All data collection and storage was approved by the institutional review board to ensure proper handling of protected health information under the Health Information Portability and Accountability Act. The diagnosis of TTTS was based on a monochorionic-diamniotic twin pregnancy with a single placenta, thin dividing membrane, and matching gender twins, with polyhydramnios in the recipient (>8 cm deepest vertical pocket of amniotic fluid) and oligohydramnios in the donor (<0.05 was assigned statistical significance. RESULTS: Study population. Four hundred and thirty-eight fetal echocardiograms for TTTS were performed within this institution during the time frame for this study. Of these, forty-four patients who received surgical intervention with adequate echocardiographic information before and after SFLP were included in the review. The mean gestational age for examination was 21.0 ± 2.5 weeks. Quintero staging in the 44 study subjects was: Stage 1, n = 1; Stage 3, n = 38; Stage 4, n = 5. Using the Cincinnati staging system, 32 were classified 3C, 6 stage 3B, 1 Stage 3A, and 5 stage 4. Data for recipient and donor twin fetal weights and deepest vertical pockets are presented in Table 1. Fetal echocardiograms were analyzed in both donors and recipients before and after (mean 4.7 ± 1.8 days) SFLP. The mean interval between initial and the post-SFLP fetal

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