title: Meconium peritonitis in both fetuses with early twin-to-twin transfusion syndrome.
abstract: Twin-to-twin transfusion syndrome (TTTS) is due to unbalanced inter-twin bloodflow through placental vascular anastomoses. We present a TTTS case treated with fetoscopic laser photocoagulation (FLP) that was complicated by perinatal meconium peritonitis in both twins. Ten weeks following laser treatment, the two fetuses showed intra-abdominal hyperechogenicity and ascites. After birth, the two newborns were surgically managed for peritonitis. We discuss the pathogenesis of this double insult. The present case highlights the role of end-circulation bowel thrombi as the potential cause of subsequent intestinal perforation.
authors.affiliation: Department of Obstetrics and Gynecology, Cochin Hospital, Paris Descartes University, Paris, France. louismarcellin@hotmail.com
authors.forename: Louis
authors.initials: L
authors.lastname: Marcellin
authors.forename: Andrea
authors.initials: A
authors.lastname: Quintana
authors.forename: Mohamed
authors.initials: M
authors.lastname: Essaoui
authors.forename: Olivia
authors.initials: O
authors.lastname: Anselem
authors.forename: Sylvie
authors.initials: S
authors.lastname: Beaudoin
authors.forename: Mayas
authors.initials: M
authors.lastname: El Ayoubi
authors.forename: Laurence
authors.initials: L
authors.lastname: Boujenah
authors.forename: Houria
authors.initials: H
authors.lastname: Salhi
authors.forename: Vassili
authors.initials: V
authors.lastname: Tsatsaris
mesh_terms: D000328:Adult; D002585:Cesarean Section; D017809:Fatal Outcome; D005260:Female; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008470:Meconium; D010538:Peritonitis / Q000209:etiology* / Q000601:surgery*; D011247:Pregnancy; D059285:Pregnancy, Twin; D016216:Ultrasonography, Prenatal