Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 3 , Pages 330-333, September 2008

Successful Treatment of Twin—Twin Transfusion Syndrome by Occlusion of Placental Vessel Anastomoses Using Enbucrilate

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, and Chang Gung University College of Medicine, Tao-Yuan, Taiwan

Accepted 14 December 2007.

Article Outline

Summary 

Objective

Twin—twin transfusion syndrome is a serious obstetric complication unique to monochorionic twin gestations. Occlusion of vessel anastomoses is recommended to improve the perinatal outcome.

Case Report

A 36-year-old, gravida 1, woman had a monochorionic twin pregnancy which was found to be affected by twin—twin transfusion syndrome at 26 weeks' gestation. The condition was successfully treated by occlusion of placental vessel anastomoses using enbucrilate under color Doppler ultrasonographic guidance. At 35 weeks of gestation, two male infants were delivered by cesarean section. The birth weights of the babies were 2,470 and 1,750 g, and both were thriving.

Conclusion

Targeted therapeutic ablation of vessel anastomoses involved in twin—twin transfusion syndrome using color Doppler ultrasonographic guidance is minimally invasive and may effectively obliterate interfetal transfusion, contributing to the survival of both twins.

Key Words:  Doppler ultrasonography , monochorionic twin , twin—twin transfusion syndrome

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Sebire NJ , Snijders RJ , Hughes K , Sepulveda W , Nicolaides KH . The hidden mortality of monochorionic twin pregnancies . Br J Obstet Gynaecol . 1997;104:1203–1207
  2. Ville Y , Hecher K , Gagnon A , Sebire N , Hyett J , Nicolaides K . Endoscopic laser coagulation in the management of severe twin-to-twin transfusion syndrome . Br J Obstet Gynaecol . 1998;105:446–453
  3. Lau TK , Yu SCH , Leung TY , To KF , Fung TY , Leung TN . Prenatal embolisation of a large chorioangioma using enbucrilate . BJOG . 2005;112:1002–1004
  4. Hecher K , Plath H , Bregenzer T , Hansmann M , Hackeloer BJ . Endoscopic laser surgery versus serial amniocenteses in the treatment of severe twin–twin transfusion syndrome . Am J Obstet Gynecol . 1999;180:717–724
  5. Fieni S , Gramellini D , Piantelli G , Verrotti C , Cavallotti D . Twin–twin transfusion syndrome: a review of treatment option . Acta Biomed . 2004;75(Suppl 1):34–39
  6. Taylor MJ , Denbow ML , Tanawattanacharoen S , Gannon C , Cox PM , Fisk NM . Doppler detection of arterio-arterial anastomoses in monochorionic twins: feasibility and clinical application . Hum Reprod . 2000;15:1632–1636
  7. Fichera A , Mor E , Soregaroli M , Frusca T . Antenatal detection of arterio-arterial anastomoses by Doppler placental assessment in monochorionic twin pregnancies . Fetal Diagn Ther . 2005;20:519–523
  8. Cheng PJ , Chueh HY , Qiu JT . Heterotopic pregnancy in a natural conception cycle presenting as hematometra . Obstet Gynecol . 2004;104:1195–1198
  9. Bowen ML , Selinger M . Episiotomy closure comparing enbucrilate tissue adhesive with conventional sutures . Int J Gynaecol Obstet . 2002;78:201–205
  10. Walker WJ . Case report: successful internal iliac artery embolisation with glue in a case of massive obstetric haemorrhage . Clin Radiol . 1996;51:442–444
  11. Dommergues M, Mandelbrot L, Delezoide AL, Aubry MC, Fermont L, Caputo-Mahieu D, et al. Twin-to-twin transfusion syndrome: selective feticide by embolization of the hydropic fetus . Fetal Diagn Ther . 1995;10:26–31
  12. Martins Santos MM, Correia LP, Rodrigues RA, Lenz Tolentino LH, Ferrari AP, Della Libera E. Splenic artery embolization and infarction after cyanoacrylate injection for esophageal varices. Gastrointest Endosc 007; 65:1088–9.

PII: S1028-4559(08)60134-5

doi:10.1016/S1028-4559(08)60134-5

Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 3 , Pages 330-333, September 2008

Article Tools