Discordant placental echogenicity: a novel sign of impaired placental perfusion in twin-twin transfusion syndrome?
Twin-twin transfusion syndrome (TTTS) is present in approximately 5-15% of monochorionic-diamniotic twin pregnancies. A chronic blood flow imbalance through placental vascular anastomoses from the donor to the recipient twin is considered the pathophysiologic mechanism responsible for the development of TTTS. Discordant echogenicity between the donor and recipient placenta has been proposed in a previous case report as an additional sonographic sign of TTTS. Here, we present a case of TTTS with discordant placental echogenicity characterized by a hyperechoic and thicker placental side in the donor twin associated with reduced vascular Doppler signals, histologic lesions suggestive of ischemic changes, and overexpression of anti-angiogenic factors.
Kusanovic
Juan Pedro
JP
Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, USA.
Romero
Roberto
R
Gotsch
Francesca
F
Mittal
Pooja
P
Erez
Offer
O
Kim
Chong Jai
CJ
Hassan
Sonia S
SS
Espinoza
Jimmy
J
Yeo
Lami
L
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D002585:Cesarean Section; D005260:Female; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007511:Ischemia / Q000473:pathology; D008297:Male; D018919:Neovascularization, Physiologic; D010920:Placenta / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D010922:Placenta Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D011247:Pregnancy; D016216:Ultrasonography, Prenatal