Hypothesis: the placental 'steal' phenomenon - a possible hazard of amnioreduction.
The twin-twin transfusion syndrome (TTTS) complicates approximately 15% of monochorionic twin pregnancies. Severe TTTS is associated with poor neonatal outcome and a relatively high rate of neurological abnormalities. Some studies have suggested this outcome to be more severe in cases treated by amnioreduction. In this paper we present a hypothesis that radical amnioreduction performed after 24 weeks of gestation might cause a shift of blood from the fetus into the placenta. This could explain some of the severe neurological outcomes, such as hypoxic ischemic brain damage, seen in these cases.
Rodeck
Charles H
CH
Department of Obstetrics and Gynaecology, University College London, UK. c.rodeck@ucl.ac.uk
Weisz
Boaz
B
Peebles
Donald M
DM
Jauniaux
Eric
E
D000653:Amniotic Fluid; D004322:Drainage / Q000009:adverse effects; D005260:Female; D005330:Fetofetal Transfusion / Q000628:therapy*; D005333:Fetus / Q000098:blood supply; D005865:Gestational Age; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology; D009422:Nervous System Diseases / Q000209:etiology; D010920:Placenta / Q000098:blood supply*; D006831:Polyhydramnios / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome