TY  - CHAP
M1  - Book, Section
TI  - Twin-to-Twin Transfusion Syndrome
A1  - Bianchi, Diana W.
A1  - Crombleholme, Timothy M.
A1  - D'Alton, Mary E.
A1  - Malone, Fergal D.
Y1  - 2015
N1  - 
T2  - Fetology: Diagnosis and Management of the Fetal Patient, 2e
AB  - Key  PointsThe  twin-to-twin  transfusion  syndrome  (TTTS)  is  a  complication  of  monochorionic  multiple  gestations  resulting  from  vascular  communications  in  the  placenta  (chorangiopagus),  such  that  one  twin  is  compromised  and  the  other  is  favored.The  prognosis  is  poor,  with  a  perinatal  mortality  rate  ranging  from  60%  to  100%  for  both  twins.TTTS  is  almost  exclusively  found  in  monochorionic  twins  and  is  estimated  to  occur  in  5%  to  15%  of  monochorionic  twin  pregnancies.Sonographic  criteria  for  the  diagnosis  of  TTTS  include:  (1)  like  sex,  (2)  monochorionic  twins,  (3)  polyhydramnios  in  one  sac,  oligohydramnios  in  the  other  sac  with  or  without  characteristic  Doppler  or  echocardiographic  changes.Expectant  management  is  not  recommended  due  to  poor  perinatal  outcomes  associated  with  the  disorder.Treatment  depends  on  the  gestational  age  and  severity  at  diagnosis.Current  treatment  options  for  severe  TTTS  include:  (1)  serial  reduction  amniocentesis,  (2)  amniotic  septostomy,  (3)  laser  ablation  of  the  anastomoses,  and  (4)  intrafetal  radiofrequency  ablation.Laser  ablation  appears  to  be  a  promising  treatment  for  severe  TTTS  diagnosed  in  the  midtrimester.  Nonetheless,  further  studies  are  still  needed  to  assess  long-term  pediatric  outcome.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/16
UR  - obgyn.mhmedical.com/content.aspx?aid=1106401334
ER  -