title: Double fatal outcome after ruptured vasa previa in monochorionic twins: case report and review of the literature.
abstract: Vasa previa is a condition in which one or more fetal blood vessels run through the amniotic membranes and cross or run near the external orifice of the uterus. Rupture of membranes can lead to tearing of these vessels and cause acute fetal exsanguination. In monochorionic twin (MC) pregnancies, acute exsanguination in one twin can lead to severe complications in the co-twin due to the presence of inter-twin placental vascular connections. We report a MC pair with severe perinatal asphyxia due to acute exsanguination after prenatally undetected ruptured vasa previa. This resulted in severe hemorrhagic shock in both twins with double fatal outcome. Antenatal detection of vasa previa is of paramount importance to prevent severe morbidity and mortality, especially in MCs. A review of the literature is presented.
authors.affiliation: a Division of Neonatology , Department of Pediatrics, Leiden University Medical Center , Leiden , the Netherlands and.
authors.forename: A
authors.initials: A
authors.lastname: van Steenis
authors.affiliation: a Division of Neonatology , Department of Pediatrics, Leiden University Medical Center , Leiden , the Netherlands and.
authors.forename: D P
authors.initials: DP
authors.lastname: Zhao
authors.affiliation: a Division of Neonatology , Department of Pediatrics, Leiden University Medical Center , Leiden , the Netherlands and.
authors.forename: S J
authors.initials: SJ
authors.lastname: Steggerda
authors.affiliation: b Division of Fetal Medicine , Department of Obstetrics, Leiden University Medical Center , Leiden , the Netherlands.
authors.forename: W J
authors.initials: WJ
authors.lastname: Kist
authors.affiliation: b 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: b 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: a Division of Neonatology , Department of Pediatrics, Leiden University Medical Center , Leiden , the Netherlands and.
authors.forename: Enrico
authors.initials: E
authors.lastname: Lopriore
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D004200:Diseases in Twins / Q000000981:diagnostic imaging* / Q000209:etiology; D058734:Exsanguination / Q000000981:diagnostic imaging* / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D010920:Placenta / Q000098:blood supply; D011247:Pregnancy; D059285:Pregnancy, Twin; D012771:Shock, Hemorrhagic / Q000000981:diagnostic imaging* / Q000209:etiology; D014430:Twins, Monozygotic; D016216:Ultrasonography, Prenatal; D055949:Vasa Previa / Q000000981:diagnostic imaging* / Q000209:etiology
keywords: Acute twin-twin transfusion syndrome, double fatal outcome; MC twin pregnancies monochorionic twins, vasa previa