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Treatment of twin-twin transfusion syndrome by laser and digoxin. Biophysical and angiographic evaluation

Arabin, B; Laurini, Ricardo LU ; van Eyck, J and Nicolaides, K H (1998) In Fetal Diagnosis and Therapy 13(3). p.141-146
Abstract
OBJECTIVES: A combination of surgical and medical approaches may address both the underlying pathophysiological processes and the most threatening symptoms in twin-twin transfusion syndrome (TTTS). CASE: A primigravida with monochorionic twin pregnancy was referred with signs of TTTS at 16 weeks. One twin was severely hydropic with normal amniotic fluid, the co-twin had anhydramnios. Laser treatment was performed. Nevertheless, signs of severe cardiac decompensation in the recipient remained unchanged. After treatment with digoxin restoration of congestive heart failure and a resolution of the hydrops were achieved. Activity and inter-twin contacts increased significantly. At 37 weeks 2 healthy boys were delivered. Postnatal... (More)
OBJECTIVES: A combination of surgical and medical approaches may address both the underlying pathophysiological processes and the most threatening symptoms in twin-twin transfusion syndrome (TTTS). CASE: A primigravida with monochorionic twin pregnancy was referred with signs of TTTS at 16 weeks. One twin was severely hydropic with normal amniotic fluid, the co-twin had anhydramnios. Laser treatment was performed. Nevertheless, signs of severe cardiac decompensation in the recipient remained unchanged. After treatment with digoxin restoration of congestive heart failure and a resolution of the hydrops were achieved. Activity and inter-twin contacts increased significantly. At 37 weeks 2 healthy boys were delivered. Postnatal computerangiography of the placenta revealed no arteriovenous anastomoses. CONCLUSIONS: This case suggests that a combined causal and symptomatic therapy in cases with cardiac decompensation of the recipient can be beneficial as demonstrated by echocardiography, venous Doppler and behavioral analysis. Computer angiography of the placenta may demonstrate the effect of laser treatment. (Less)
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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Placental evaluation, Digoxin, Twin-twin transfusionsyndrome, Laser treatment, Computer angiography
in
Fetal Diagnosis and Therapy
volume
13
issue
3
pages
141 - 146
publisher
Karger
external identifiers
  • pmid:9708434
  • scopus:7344233687
ISSN
1015-3837
DOI
10.1159/000020825
language
English
LU publication?
no
id
8c9dc28e-7f28-4719-8c2d-b2ac588b1587 (old id 1113993)
date added to LUP
2008-07-16 14:43:00
date last changed
2017-06-25 03:31:22
@article{8c9dc28e-7f28-4719-8c2d-b2ac588b1587,
  abstract     = {OBJECTIVES: A combination of surgical and medical approaches may address both the underlying pathophysiological processes and the most threatening symptoms in twin-twin transfusion syndrome (TTTS). CASE: A primigravida with monochorionic twin pregnancy was referred with signs of TTTS at 16 weeks. One twin was severely hydropic with normal amniotic fluid, the co-twin had anhydramnios. Laser treatment was performed. Nevertheless, signs of severe cardiac decompensation in the recipient remained unchanged. After treatment with digoxin restoration of congestive heart failure and a resolution of the hydrops were achieved. Activity and inter-twin contacts increased significantly. At 37 weeks 2 healthy boys were delivered. Postnatal computerangiography of the placenta revealed no arteriovenous anastomoses. CONCLUSIONS: This case suggests that a combined causal and symptomatic therapy in cases with cardiac decompensation of the recipient can be beneficial as demonstrated by echocardiography, venous Doppler and behavioral analysis. Computer angiography of the placenta may demonstrate the effect of laser treatment.},
  author       = {Arabin, B and Laurini, Ricardo and van Eyck, J and Nicolaides, K H},
  issn         = {1015-3837},
  keyword      = {Placental evaluation,Digoxin,Twin-twin transfusionsyndrome,Laser treatment,Computer angiography},
  language     = {eng},
  number       = {3},
  pages        = {141--146},
  publisher    = {Karger},
  series       = {Fetal Diagnosis and Therapy},
  title        = {Treatment of twin-twin transfusion syndrome by laser and digoxin. Biophysical and angiographic evaluation},
  url          = {http://dx.doi.org/10.1159/000020825},
  volume       = {13},
  year         = {1998},
}