title: The role of veno-venous anastomoses in twin-twin transfusion syndrome.
abstract: The aim of this study was to investigate the independent role of veno-venous (VV) anastomoses in the development of twin-twin transfusion syndrome (TTTS). Thirty TTTS placentas and 41 non-TTTS placentas, routinely injected with colored dye, were enrolled in this study. We excluded all cases with arterio-arterial (AA) anastomoses and TTTS cases treated with laser surgery. The prevalence of VV anastomoses was significantly higher in TTTS cases compared to non-TTTS cases, 37% (11/30) and 7% (3/41), respectively (P < .01; odds ratio 7.3; 95% confidence interval: 1.8-37.1). Our findings suggest that, in the absence of AA anastomoses, VV anastomoses may enhance the development of TTTS.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, J6-S, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. Electronic address: d.zhao@lumc.nl.
authors.forename: D P
authors.initials: DP
authors.lastname: Zhao
authors.affiliation: Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Cohen
authors.affiliation: Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Middeldorp
authors.affiliation: Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: F J
authors.initials: FJ
authors.lastname: Klumper
authors.affiliation: Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: M C
authors.initials: MC
authors.lastname: Haak
authors.affiliation: Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Oepkes
authors.affiliation: Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, J6-S, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. Electronic address: e.lopriore@lumc.nl.
authors.forename: E
authors.initials: E
authors.lastname: Lopriore
mesh_terms: D005260:Female; D005330:Fetofetal Transfusion / Q000473:pathology*; D006801:Humans; D055806:Microvessels / Q000473:pathology*; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D014680:Veins / Q000473:pathology*
keywords: Monochorionic twins; Twin–twin transfusion syndrome; Veno-venous anastomosis