Selective cord coagulation in acardiac twins.
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Selective cord coagulation in acardiac twins. / Diehl, Werner; Hecher, Kurt.
in: SEMIN FETAL NEONAT M, Jahrgang 12, Nr. 6, 6, 2007, S. 458-463.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Selective cord coagulation in acardiac twins.
AU - Diehl, Werner
AU - Hecher, Kurt
PY - 2007
Y1 - 2007
N2 - The twin reverse arterial perfusion (TRAP) sequence is a serious complication of monochorionic multiple pregnancies in which the affected twin is reversely perfused from the healthy co-twin, resulting in severely abnormal or absent cardiac development, severe malformations, and massive hydrops fetalis. The acardiac twin threatens the survival of the pump twin either by increasing the risk of congestive cardiac failure or by the development of polyhydramnios, preterm premature rupture of membranes, preterm labour and premature delivery. A wide spectrum of surgical interventions has been applied in the management of TRAP; however, because of the rarity of this condition and the heterogeneity of its presentation, no single technique has been shown to be unequivocally optimal. In our experience, fetoscopic laser coagulation of the placental vascular anastomoses or the umbilical cord of the acardiac twin, with the possibility of applying bipolar forceps as an additional minimally invasive surgical technique, offers an effective treatment option in the management of the TRAP sequence; this treatment has a survival rate of 80%, and 67% of pregnancies with surviving pump twins go beyond 36 weeks of gestation without further complications.
AB - The twin reverse arterial perfusion (TRAP) sequence is a serious complication of monochorionic multiple pregnancies in which the affected twin is reversely perfused from the healthy co-twin, resulting in severely abnormal or absent cardiac development, severe malformations, and massive hydrops fetalis. The acardiac twin threatens the survival of the pump twin either by increasing the risk of congestive cardiac failure or by the development of polyhydramnios, preterm premature rupture of membranes, preterm labour and premature delivery. A wide spectrum of surgical interventions has been applied in the management of TRAP; however, because of the rarity of this condition and the heterogeneity of its presentation, no single technique has been shown to be unequivocally optimal. In our experience, fetoscopic laser coagulation of the placental vascular anastomoses or the umbilical cord of the acardiac twin, with the possibility of applying bipolar forceps as an additional minimally invasive surgical technique, offers an effective treatment option in the management of the TRAP sequence; this treatment has a survival rate of 80%, and 67% of pregnancies with surviving pump twins go beyond 36 weeks of gestation without further complications.
M3 - SCORING: Zeitschriftenaufsatz
VL - 12
SP - 458
EP - 463
JO - SEMIN FETAL NEONAT M
JF - SEMIN FETAL NEONAT M
SN - 1744-165X
IS - 6
M1 - 6
ER -