title: Color Doppler ultrasonography in the identification of communicating vessels in twin-twin transfusion syndrome and acardiac twins.
abstract: This study evaluates the role of color Doppler ultrasonography in the identification of the communicating placental vessels in pregnancies with twin-twin transfusion syndrome and acardiac twins. In 18 pregnancies with twin-twin transfusion syndrome and two with an acardiac twin, color Doppler studies of the placental vasculature were performed before fetoscopy for laser coagulation of the communicating vessels. In six cases of twin-twin transfusion syndrome the placental attachment of the intertwin membrane could be visualized. Pulsatile arterial blood flow was observed from the donor to the recipient twin that disappeared after laser therapy. In both cases of acardiac twins, one communicating vessel with pulsatile and another vessel with nonpulsatile blood flow in the opposite direction could be identified. Color Doppler imaging is unlikely to play a major role in assisting endoscopic laser separation of chorioangiopagus in patients with acute polyhydramnios, but it may prove to be useful in the early identification of pregnancies at risk of developing twin-twin transfusion syndrome.
authors.affiliation: Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, London, England.
authors.forename: K
authors.initials: K
authors.lastname: Hecher
authors.forename: Y
authors.initials: Y
authors.lastname: Ville
authors.forename: K H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000208:Acute Disease; D000650:Amnion / Q000098:blood supply / Q000000981:diagnostic imaging; D001158:Arteries / Q000002:abnormalities / Q000000981:diagnostic imaging; D002823:Chorion / Q000000981:diagnostic imaging; D004200:Diseases in Twins; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging* / Q000601:surgery; D005332:Fetoscopy; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D017075:Laser Coagulation; D010920:Placenta / Q000098:blood supply* / Q000601:surgery; D006831:Polyhydramnios / Q000000981:diagnostic imaging / Q000601:surgery; D011247:Pregnancy; D011673:Pulsatile Flow / Q000502:physiology; D012307:Risk Factors; D014430:Twins, Monozygotic; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014470:Umbilical Cord / Q000098:blood supply / Q000000981:diagnostic imaging