[Monochorionic twin pregnancies : dangerous liasons].
Monochorionic twin pregnancies are characterized by a shared placental circulation; this induces a high degree of hemodynamic interdependency between the twins. This is particularly dramatic in twin-to-twin transfusion syndrome or when one twin dies in utero. In both conditions, the severity of the hemodynamic imbalance can lead to significant sequelae in 15-25% of the cases. Ischemic accidents can be prevented by interruption of placental anastomoses through laser coagulation of their chorionic branches. This can be performed when intrauterine death of one twin is inevitable or as a first line treatment in severe TTS. In the latter indication it is important to compare this approach with serial amniodrainage.
Ville
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Département de Gynécologie Obstétrique, Université Paris V, CHI Poissy-St Germain, 78303 Poissy cedex, France. yville@wanadoo.fr.
D000649:Amniocentesis; D002823:Chorion / Q000098:blood supply; D004200:Diseases in Twins; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005330:Fetofetal Transfusion / Q000209:etiology / Q000628:therapy; D006801:Humans; D017075:Laser Coagulation; D011247:Pregnancy; D011272:Pregnancy, Multiple; D015145:Tocolysis