Journal
PLACENTA
Volume 30, Issue 3, Pages 223-225Publisher
W B SAUNDERS CO LTD
DOI: 10.1016/j.placenta.2008.11.012
Keywords
Twin-to-twin transfusion syndrome; Placental vascular anastomoses; Inter-twin blood flow
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Twin-to-twin transfusion syndrome (TTTS) is due to unbalanced inter-twin blood flow through placental vascular anastomoses. We present a TTTS-case treated with fetoscopic laser surgery that allowed us to calculate the net inter-twin blood flow. In the weeks following laser treatment, the ex-recipient developed severe fetal anemia and was treated with two intrauterine adult red cell transfusions (at 26 and 29 weeks' gestation, respectively). After birth, placental injection with color-latex identified a single residual arterio-venous anastomosis from the ex-recipient to the ex-donor. We measured the fetal and adult hemoglobin concentrations in the anemic fetus before and after both intrauterine transfusions, and in both twins at birth. On the basis of these measurements, we calculated the blood flow across the residual arterio-venous anastomosis and found it to be 5.8 +/- 1.5 mL/24 h after the 1st transfusion and 11.4 +/- 2.9 mL/24 h after the 2nd transfusion. (C) 2008 Elsevier Ltd. All rights reserved.
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