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.
Department of Obstetrics and Gynecology, Osaka Medical Center Maternal and Child Health, Osaka, Japan. take@gyne.med.osaka-u.ac.jp
Takashi
T
Takeda
Ryoko
R
Minekawa
Mayuko
M
Makino
Takashi
T
Sugiyama
Yuji
Y
Murata
Noriyuki
N
Suehara
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