title: Selective feticide by embolization in twin-twin transfusion syndrome. A report of two cases.
abstract: BACKGROUND
  The early development of complications in twin-twin transfusion syndrome is a poor prognostic sign. For this reason, new techniques for intrauterine therapy are being developed: invasive options, such as selective feticide of one of the twins, have been reported.
  
  
  METHODS
  Two cases of twin-twin transfusion syndrome in the late second trimester were treated by selective feticide using vascular embolization to the more severely damaged fetus. In one case the embolized fetus was a hydropic recipient with a normal cotwin; in the other, the donor fetus was affected by bilateral hydrocephalus. These fetuses underwent ultrasound-guided embolization using a bolus of histoacryl injected into the umbilical vein and fetal heart. Both patients went on to deliver healthy singletons in the third trimester.
  
  
  CONCLUSIONS
  In twin-twin transfusion syndrome of early onset, embolization may help one of the twins survive. This technique is neither time-consuming nor expensive and does not require a general anesthetic.
authors.affiliation: Department of Obstetrics and Gynecology, Pathology and Pediatrics, Erasme Hospital, Free University of Brussels, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Donner
authors.forename: S
authors.initials: S
authors.lastname: Shahabi
authors.forename: D
authors.initials: D
authors.lastname: Thomas
authors.forename: J C
authors.initials: JC
authors.lastname: Noël
authors.forename: C
authors.initials: C
authors.lastname: Kirkpatrick
authors.forename: M V
authors.initials: MV
authors.lastname: Rysselberghe
authors.forename: C
authors.initials: C
authors.lastname: Hubinon
authors.forename: D
authors.initials: D
authors.lastname: Vermeylen
authors.forename: L
authors.initials: L
authors.lastname: Masters
authors.forename: F
authors.initials: F
authors.lastname: Rodesch
mesh_terms: D000328:Adult; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005330:Fetofetal Transfusion / Q000628:therapy*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal / Q000379:methods*; D011262:Pregnancy Trimester, Second; D014427:Twins