Hyperreactio luteinalis associated with severe twin-to-twin transfusion syndrome.
Twin-to-twin transfusion syndrome (TTTS) is a severe complication of monochorionic twin pregnancies, with high perinatal loss and significant morbidity. The etiology of this syndrome remains unclear. Hyperreactio luteinalis is a rare benign condition characterized by maternal ovarian enlargement due to theca lutein cysts. We present 4 cases of hyperreactio luteinalis associated with severe TTTS. We detected maternal ovarian enlargement by prenatal ultrasonography in 2 cases, at the cesarean section in 1 case, and postpartum in 1 case. Three cases showed hydrops fetalis and all cases showed congestive cardiac failure. Serial amnioreduction was performed in all cases, and regression of hydrops fetalis and maternal ovarian enlargement occurred in 1 case. These cases suggest that the pathophysiology of TTTS is closely related to the etiology of hyperreactio luteinalis.
Takeda
Takashi
T
Department of Obstetrics and Gynecology, Osaka Medical Center Maternal and Child Health, Osaka, Japan. take@gyne.med.osaka-u.ac.jp
Minekawa
Ryoko
R
Makino
Mayuko
M
Sugiyama
Takashi
T
Murata
Yuji
Y
Suehara
Noriyuki
N
D000328:Adult; D002585:Cesarean Section; D005260:Female; D005313:Fetal Death; D005330:Fetofetal Transfusion / Q000150:complications / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006801:Humans; D015160:Hydrops Fetalis / Q000150:complications / Q000000981:diagnostic imaging*; D007231:Infant, Newborn; D016471:Ovarian Hyperstimulation Syndrome / Q000150:complications / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D012494:Sampling Studies; D014427:Twins; D016216:Ultrasonography, Prenatal