Prenatal surveillance and management of twin-to-twin transfusion syndrome

A case with improvement of ultrasonic parameters

L. Chuang, Chen-Hsiang Yu, Chiung-Hsin Chang, F. M. Chang

Research output: Contribution to journalArticle

Abstract

We report here a very rare case of twin-to-twin transfusion syndrome (TTS) showing remarkable clinical improvement after treatment with amnioreduction at 25 weeks of gestation. After amnioreduction, three changes were observed. Firstly, fetal ascites disappeared in the growth-restricted fetus (the donor). Secondly, the flow velocity waveforms (FVW) in the umbilical artery of the donor changed from reverse-end-diastolic velocity to absent-end-diastolic velocity. Thirdly, the oligohydramniotic state in the donor improved with more amniotic fluid, despite not having reached the normal amount. Meanwhile, polyhydramnios in the larger fetus also improved with decreased amniotic fluid nearer the normal range. To date, the mechanism of the flow velocity change after amnioreduction is unclear, but might be due to increased uteroplacental perfusion or the reverse of the pathophysiology of TTS affected by amnioreduction. Further studies on FVW in TTS are warranted.

Original languageEnglish
Pages (from-to)243-247
Number of pages5
JournalJournal of Medical Ultrasound
Volume8
Issue number4
Publication statusPublished - 2000 Jan 1

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Fetofetal Transfusion
Ultrasonics
Amniotic Fluid
Fetus
Polyhydramnios
Umbilical Arteries
Ascites
Reference Values
Perfusion
Pregnancy
Growth

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

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abstract = "We report here a very rare case of twin-to-twin transfusion syndrome (TTS) showing remarkable clinical improvement after treatment with amnioreduction at 25 weeks of gestation. After amnioreduction, three changes were observed. Firstly, fetal ascites disappeared in the growth-restricted fetus (the donor). Secondly, the flow velocity waveforms (FVW) in the umbilical artery of the donor changed from reverse-end-diastolic velocity to absent-end-diastolic velocity. Thirdly, the oligohydramniotic state in the donor improved with more amniotic fluid, despite not having reached the normal amount. Meanwhile, polyhydramnios in the larger fetus also improved with decreased amniotic fluid nearer the normal range. To date, the mechanism of the flow velocity change after amnioreduction is unclear, but might be due to increased uteroplacental perfusion or the reverse of the pathophysiology of TTS affected by amnioreduction. Further studies on FVW in TTS are warranted.",
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AB - We report here a very rare case of twin-to-twin transfusion syndrome (TTS) showing remarkable clinical improvement after treatment with amnioreduction at 25 weeks of gestation. After amnioreduction, three changes were observed. Firstly, fetal ascites disappeared in the growth-restricted fetus (the donor). Secondly, the flow velocity waveforms (FVW) in the umbilical artery of the donor changed from reverse-end-diastolic velocity to absent-end-diastolic velocity. Thirdly, the oligohydramniotic state in the donor improved with more amniotic fluid, despite not having reached the normal amount. Meanwhile, polyhydramnios in the larger fetus also improved with decreased amniotic fluid nearer the normal range. To date, the mechanism of the flow velocity change after amnioreduction is unclear, but might be due to increased uteroplacental perfusion or the reverse of the pathophysiology of TTS affected by amnioreduction. Further studies on FVW in TTS are warranted.

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