Feto-fetal transfusion syndrome(FFTS)severely affects monochorionic(MC)multiple pregnancies and affects 1 in 1600 pregnancies overall.The number of increasing disputed obstetrics cases in China is related to unavailab...Feto-fetal transfusion syndrome(FFTS)severely affects monochorionic(MC)multiple pregnancies and affects 1 in 1600 pregnancies overall.The number of increasing disputed obstetrics cases in China is related to unavailability of prompt diagnosis of FFTS.We present here a woman with a MC triplet pregnancy with intrauterine fetal death at 33 weeks of gestation due to FFTS.Subsequent pathological anatomy showed that the MC placenta contained vascular anastomoses,including arterio-arterial anastomosis and arterio-venous anastomosis.These anastomoses led to unidirectional blood flow with the absence of adequate compensatory counter-transfusion and bi-directional flow.When encountering such challenging conditions,medical practitioners should discreetly compare the fetuses’characteristics with features of placental blood vessels and consult morphological and pathological findings.Furthermore,they should perform ultrasound examinations,particularly focussing on fetal size differences and the maximum vertical pocket in the diagnosis of FFTS,especially in MC multiple pregnancies with abdominal symptoms.展开更多
Limb Body Wall Complex (LBWC) is a rare heterogenic group of fetal malformations including major defects of the ventral body (thoracoabdominal) wall associated with other anomalies including those of the limbs that ma...Limb Body Wall Complex (LBWC) is a rare heterogenic group of fetal malformations including major defects of the ventral body (thoracoabdominal) wall associated with other anomalies including those of the limbs that may range from amelia to mild positional deformations, unusual craniofacial malformations, and a variety of visceral abnormalities that include the heart, lungs, genitourinary system. Tow phenotypes are described according to the feto-placental attachment. We report a particular case and iconography of LBWC associated with a giant sacral meningocele never described before. The patient was 26 years old, primigravida, with no illnesses or recent infections. She had no history of prenatal exposure to teratogenic agents, nor any family history of congenital malformations. She was referred for polymalformatif syndrome at 30 gestation weeks. Advanced sonography showed giant omphalocel with eviscerated liver, stomac and kidney, club feet, kyphoscoliosis and giant sacral fluid cyst. A 2100 g fetus was delivered, post natal examination confirmed LBWC with abdominoplacental attachment and the particularity of the presence of giant sacral meningocele, two bilateral hemi-genital tubercles and anal atresia.展开更多
One in three monochorionic twins may develop complications during pregnancy. Monochorionic twins, especially monochorionic diamniotic (MCDA), present specific problems caused by the presence of interfetal placental an...One in three monochorionic twins may develop complications during pregnancy. Monochorionic twins, especially monochorionic diamniotic (MCDA), present specific problems caused by the presence of interfetal placental anastomoses. The first critical step in the management of MCDA twins is identification in the first trimester. Secondly, close follow-up every 2 weeks is mandatory to allow early diagnosis and timely treatment of twin-twin transfusion syndrome. Other potentially severe complications include selective fetal growth restriction, twin anemia polycythemia syndrome or single fetal death. Thirdly, a correct differential diagnosis is critical to establish the best therapy. This may represent a clinical challenge since MCDA twin complications often overlap. A simple diagnostic algorithm may be of great help to establish the right diagnosis and management option. In this review we summarize the main steps for the clinical follow-up, differential diagnosis, and targeted management of MCDA twins complications.展开更多
基金supported by the National Natural Science Foundation of China[grant number 81373249],[grant num-ber 81571855]Mittal Student Innovation Test Plan of Cen-tral South University[grant number MX2016447]Student Innovation Test Plan of Central South University[grant number CX2016343],[grant number YC2016714].
文摘Feto-fetal transfusion syndrome(FFTS)severely affects monochorionic(MC)multiple pregnancies and affects 1 in 1600 pregnancies overall.The number of increasing disputed obstetrics cases in China is related to unavailability of prompt diagnosis of FFTS.We present here a woman with a MC triplet pregnancy with intrauterine fetal death at 33 weeks of gestation due to FFTS.Subsequent pathological anatomy showed that the MC placenta contained vascular anastomoses,including arterio-arterial anastomosis and arterio-venous anastomosis.These anastomoses led to unidirectional blood flow with the absence of adequate compensatory counter-transfusion and bi-directional flow.When encountering such challenging conditions,medical practitioners should discreetly compare the fetuses’characteristics with features of placental blood vessels and consult morphological and pathological findings.Furthermore,they should perform ultrasound examinations,particularly focussing on fetal size differences and the maximum vertical pocket in the diagnosis of FFTS,especially in MC multiple pregnancies with abdominal symptoms.
文摘Limb Body Wall Complex (LBWC) is a rare heterogenic group of fetal malformations including major defects of the ventral body (thoracoabdominal) wall associated with other anomalies including those of the limbs that may range from amelia to mild positional deformations, unusual craniofacial malformations, and a variety of visceral abnormalities that include the heart, lungs, genitourinary system. Tow phenotypes are described according to the feto-placental attachment. We report a particular case and iconography of LBWC associated with a giant sacral meningocele never described before. The patient was 26 years old, primigravida, with no illnesses or recent infections. She had no history of prenatal exposure to teratogenic agents, nor any family history of congenital malformations. She was referred for polymalformatif syndrome at 30 gestation weeks. Advanced sonography showed giant omphalocel with eviscerated liver, stomac and kidney, club feet, kyphoscoliosis and giant sacral fluid cyst. A 2100 g fetus was delivered, post natal examination confirmed LBWC with abdominoplacental attachment and the particularity of the presence of giant sacral meningocele, two bilateral hemi-genital tubercles and anal atresia.
文摘One in three monochorionic twins may develop complications during pregnancy. Monochorionic twins, especially monochorionic diamniotic (MCDA), present specific problems caused by the presence of interfetal placental anastomoses. The first critical step in the management of MCDA twins is identification in the first trimester. Secondly, close follow-up every 2 weeks is mandatory to allow early diagnosis and timely treatment of twin-twin transfusion syndrome. Other potentially severe complications include selective fetal growth restriction, twin anemia polycythemia syndrome or single fetal death. Thirdly, a correct differential diagnosis is critical to establish the best therapy. This may represent a clinical challenge since MCDA twin complications often overlap. A simple diagnostic algorithm may be of great help to establish the right diagnosis and management option. In this review we summarize the main steps for the clinical follow-up, differential diagnosis, and targeted management of MCDA twins complications.
