期刊
FETAL DIAGNOSIS AND THERAPY
卷 42, 期 3, 页码 232-235出版社
KARGER
DOI: 10.1159/000476033
关键词
Perimortem hemorrhage; Twin-twin transfusion syndrome; Fetal-to-fetal hemorrhage; Ultrasound-guided cord occlusion; Fetal middle cerebral artery peak systolic velocity; Fetal anemia
Twin-twin transfusion syndrome is a complication of monochorionic-diamniotic placentation. Should one twin die, approximate to 30% of co-twins will also die, and if they survive, approximate to 30% experience severe morbidity rates, each believed secondary to hemorrhage of the co-twin into the deceased twin. We report apparently the first ultrasound-documented case of perimortem hemorrhage in twin-twin transfusion syndrome and its treatment by emergent ultrasound-guided percutaneous cord occlusion followed by percutaneous fetal intravascular transfusion. The case illustrates three important pathophysiologic events. First, it confirms acute twin-to-twin hemorrhage occurs and reveals it can begin before the first twin dies. Thus, delivery of the survivor after its dead co-twin is discovered is unlikely to protect the survivor. Second, the elevated fetal middle cerebral artery peak systolic velocity due to acute anemia requires hours to develop. And thirdly, intracardiac epinephrine can correct the acute fetal bradycardia associated with hemorrhage that is presumably due to fetal hypotension. (C) 2017 S. Karger AG, Basel
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据