Treatment of Acardiac Twinning
| Autor: | Richard J. Gimpelson, Fernando Arias, Shiraz Sunderji, Eric Colton |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Twin reversed arterial perfusion Umbilical cord Ultrasonography Prenatal Umbilical Arteries Pregnancy Ductus arteriosus Anencephaly Diseases in Twins Humans Medicine Laser Coagulation business.industry Fetal surgery Infant Newborn Obstetrics and Gynecology Gestational age medicine.disease Surgery Fetal Diseases medicine.anatomical_structure Abnormalities Severe Teratoid Female business Complication Laser coagulation |
| Zdroj: | Obstetrics & Gynecology. 91:818-821 |
| ISSN: | 0029-7844 |
| DOI: | 10.1016/s0029-7844(97)00708-4 |
| Popis: | Background: The twin reversed-arterial-perfusion sequence is a complication of monochorionic twin pregnancies characterized by the hemodynamic dependence of a “recipient” twin from a “pump” twin. The recipient twin exhibits lethal abnormalities including acardia and acephaly. The pump twin has a mortality rate of 50% as a result of high-output heart failure. Case: The blood supply to an acardiac-acephalus twin was interrupted at 24 weeks’ gestation using endoscopic laser coagulation. The co-twin was delivered at 35 weeks and had an uneventful neonatal course following correction of a persistent patent ductus arteriosus. Review of the literature reveals 22 cases of acardiac twinning treated with invasive procedures, seven of them using endoscopic laser coagulation. Pump twin mortality with fetal surgery was 13.6% in comparison with 50% mortality with expectant management ( P Conclusion: Fetal surgery is the best available treatment for acardiac twinning. Endoscopic laser coagulation at or before 24 weeks and endoscopic or sonographic guided umbilical cord ligation after this gestational age seem to be the best treatments for this condition. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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