Objective: The objective of the study was to determine the incidence, origin, and character of cerebral lesions in monochorionic twins with twin-to-twin transfusion syndrome treated with fetoscopic laser surgery. Stud...Objective: The objective of the study was to determine the incidence, origin, and character of cerebral lesions in monochorionic twins with twin-to-twin transfusion syndrome treated with fetoscopic laser surgery. Study design: This was a prospective study of monochorionic twins with twin-to-twin transfusion syndrome treated with fetoscopic laser surgery and monochorionic twins without twin-to-twin transfusion syndrome delivered at our center between June 2002 and September 2005, using cranial ultrasonography. Results: Incidence of antenatally acquired severe cerebral lesions in the twin-to-twin transfusion syndrome group was 10% (8/84) and 2% (2/108) in the non-twin-to-twin transfusion syndrome group (P = .02) . Incidence of severe cerebral lesions at discharge was 14% (12/84) in the twin-to-twin transfusion syndrome group and 6% (6/108) in the non-twin-to-twin transfusion syndrome group (P = .04). Antenatal injury was responsible for severe cerebral lesions in 67% (8/12) of the twin-to-twin transfusion syndrome group. Conclusion: Incidence of severe cerebral lesions in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery is high and results mainly from antenatal injury.展开更多
Objective: This study was undertaken to report the occurrence of bipartite monochorionic twin placentas. Study design: Examination of 109 monochorionic placentas delivered at our institution between June 2002 and June...Objective: This study was undertaken to report the occurrence of bipartite monochorionic twin placentas. Study design: Examination of 109 monochorionic placentas delivered at our institution between June 2002 and June 2005 was performed. Placental characteristics on prenatal ultrasound were studied, including single or double appearance and type of intertwin membrane-placental junction (“ T" sign or lambda sign). Monochorionicity was confirmed by postnatal histologic confirmation (diamniotic intertwin membrane without chorionic tissue within the dividing septum). Bipartition was diagnosed when 2 separate placental masses attached by membranes were identified. Results: Of the 109 monochorionic placentas, 3 were composed of 2 separate placental masses. Prenatal ultrasound examination showed 2 separate placental masses in each case. Monochorionicity was suspected on prenatal ultrasound because of the presence of “ T" sign in 2 cases and twin-to-twin transfusion syndrome (TTTS)- in another case. Microscopic examination of the dividing septum was consistent with monochorionicity in each case. Vascular anastomoses were present in 2 of the 3 placentas, and led in both cases to the development of TTTS. Conclusion: Two separate placental masses in twin pregnancies are not per se dichorionic and may occur in almost 3% of monochorionic placentas.展开更多
文摘Objective: The objective of the study was to determine the incidence, origin, and character of cerebral lesions in monochorionic twins with twin-to-twin transfusion syndrome treated with fetoscopic laser surgery. Study design: This was a prospective study of monochorionic twins with twin-to-twin transfusion syndrome treated with fetoscopic laser surgery and monochorionic twins without twin-to-twin transfusion syndrome delivered at our center between June 2002 and September 2005, using cranial ultrasonography. Results: Incidence of antenatally acquired severe cerebral lesions in the twin-to-twin transfusion syndrome group was 10% (8/84) and 2% (2/108) in the non-twin-to-twin transfusion syndrome group (P = .02) . Incidence of severe cerebral lesions at discharge was 14% (12/84) in the twin-to-twin transfusion syndrome group and 6% (6/108) in the non-twin-to-twin transfusion syndrome group (P = .04). Antenatal injury was responsible for severe cerebral lesions in 67% (8/12) of the twin-to-twin transfusion syndrome group. Conclusion: Incidence of severe cerebral lesions in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery is high and results mainly from antenatal injury.
文摘Objective: This study was undertaken to report the occurrence of bipartite monochorionic twin placentas. Study design: Examination of 109 monochorionic placentas delivered at our institution between June 2002 and June 2005 was performed. Placental characteristics on prenatal ultrasound were studied, including single or double appearance and type of intertwin membrane-placental junction (“ T" sign or lambda sign). Monochorionicity was confirmed by postnatal histologic confirmation (diamniotic intertwin membrane without chorionic tissue within the dividing septum). Bipartition was diagnosed when 2 separate placental masses attached by membranes were identified. Results: Of the 109 monochorionic placentas, 3 were composed of 2 separate placental masses. Prenatal ultrasound examination showed 2 separate placental masses in each case. Monochorionicity was suspected on prenatal ultrasound because of the presence of “ T" sign in 2 cases and twin-to-twin transfusion syndrome (TTTS)- in another case. Microscopic examination of the dividing septum was consistent with monochorionicity in each case. Vascular anastomoses were present in 2 of the 3 placentas, and led in both cases to the development of TTTS. Conclusion: Two separate placental masses in twin pregnancies are not per se dichorionic and may occur in almost 3% of monochorionic placentas.
