Twin-Twin Transfusion Syndrome in Cases with Suspected Close Proximity of Umbilical Cord Insertions.
We encountered 3 cases of twin-twin transfusion syndrome (TTTS), in which preoperative ultrasonography revealed that the cord insertion sites of the twins were close. Two cases were successfully treated with fetoscopic laser photocoagulation (FLP); however, the third case could not be treated surgically because fetoscopy revealed that the cord insertions formed a V-shaped joint above the placenta and that all chorionic vessels of the placental surface were shared by the twins. No residual anastomoses were detected on placental examination in the 2 cases treated with FLP. Our experiences indicate that the feasibility of FLP could be evaluated using fetoscopy, not just ultrasonography, in cases of TTTS accompanied by proximate umbilical cord insertion.
Department of Maternal Fetal Medicine, Osaka Prefectural Hospital Organization, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan.
Yuka
Y
Sato
Keisuke
K
Ishii
Naoto
N
Yonetani
Ryo
R
Yamamoto
Nobuaki
N
Mitsuda
D005260:Female; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005332:Fetoscopy; D006801:Humans; D008028:Light Coagulation; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D014470:Umbilical Cord / Q000000981:diagnostic imaging*