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Chapter 32 - Twin-to-Twin Transfusion Syndrome: Treatment by Fetoscopic Laser Coagulation of the Placental Vascular Anastomoses on the Chorionic Plate

from Complications of Monochorionic Multiple Pregnancy: Twin-to-Twin Transfusion Syndrome

Published online by Cambridge University Press:  21 October 2019

By
Gihad E. Chalouhi ,
Julien Stirnemann ,
Claire Colmant  and
Yves Ville
Edited by
Mark D. Kilby ,
Anthony Johnson  and
Dick Oepkes
Mark D. Kilby
Affiliation:
University of Birmingham
Anthony Johnson
Affiliation:
University of Texas Medical School at Houston
Dick Oepkes
Affiliation:
Leids Universitair Medisch Centrum
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Summary

Monochorionic twin placentation occurs in 20% of spontaneous twin pregnancies and almost 5% of those are obtained by medically assisted reproduction [1]. Monochorionic twin fetuses have the unique characteristic of living upon one single placenta and therefore share some cotyledons through vascular anastomoses running on the chorionic plate. This situation can lead to specific complications, including twin-to-twin transfusion syndrome (TTTS) [2, 3], twin-anemia-polycythemia sequence (TAPS) [4, 5], and selective intrauterine growth restriction (sIUGR) [6]. These complications are likely to explain most of the 6- to 12-fold increase in perinatal mortality in monochorionic compared with dichorionic twins [7–10].

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Chapter
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Fetal Therapy
Scientific Basis and Critical Appraisal of Clinical Benefits
 , pp. 353 - 362
Publisher: Cambridge University Press
Print publication year: 2020

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