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The prevalence and clinical features of twin-twin transfusion syndrome with onset during the third trimester

  • Masaharu Murata EMAIL logo , Keisuke Ishii , Takako Taguchi , Aki Mabuchi , Haruna Kawaguchi , Ryo Yamamoto , Shusaku Hayashi and Nobuaki Mitsuda
Published/Copyright: August 29, 2013
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 42 Issue 1

Abstract

Objective: To describe the incidence and clinical features of twin-twin transfusion syndrome (TTTS) with third trimester onset.

Methods: We performed a retrospective chart review of monochorionic diamniotic (MD) twin pregnancies delivered during a recent 4-year period. The inclusion criterion was women who received prenatal care at our center from the first trimester onward. Serial ultrasound examinations were performed at least every 2 weeks until delivery to evaluate fetal growth as well as to estimate amniotic fluid volume. The prevalence of TTTS onset after 28 weeks of gestation and clinical features, including neonatal outcomes and placental findings, were elucidated.

Results: Meeting our inclusion criterion were 143 MD twin pregnancies, including 15 TTTS cases (10%). Five cases (4%) developed TTTS during the third trimester and underwent a cesarean section immediately after the diagnosis. All of these women exhibited either abdominal distension or uterine contractions. Recipient twins tended to require more intensive cardiopulmonary treatment than donors, however, neither a recipient nor a donor twin suffered neonatal death or neurological impairment. Placental arterio-arterial anastomoses were detected in three out of five cases. Arteriovenous anastomoses were present in all cases, however, venovenous anastomoses were not found in any case.

Conclusions: TTTS is a relatively rare complication during the third trimester. It is imperative to be observant for the development of TTTS in MD twin pregnancies with any abdominal symptoms, even if they appear insignificant.

Keywords: Monochorionic diamniotic twin pregnancy; perinatal outcome; third trimester; twin-twin transfusion syndrome
Corresponding author: Masaharu Murata, MD, PhD, Department of Maternal Fetal Medicine, Osaka Prefectural Hospital Organization, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan, Tel.: +81-752-56-1220, Fax: +81-725-57-3207, E-mail:

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2013-5-10
Accepted: 2013-7-26
Published Online: 2013-08-29
Published in Print: 2014-01-01

©2014 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/jpm-2013-0101
Keywords for this article
Monochorionic diamniotic twin pregnancy; perinatal outcome; third trimester; twin-twin transfusion syndrome

Articles in the same Issue

  1. Masthead
  2. Masthead
  3. Recommendation and Guidelines for Perinatal Practice
  4. Inactivation of high-risk human papillomaviruses by Holder pasteurization: implications for donor human milk banking
  5. Review article
  6. Breastfeeding is natural but not always easy: intervention for common medical problems of breastfeeding mothers – a review of the scientific evidence
  7. Original article – Obstetrics
  8. Maternal mortality due to pandemic influenza A H1N1 2009 virus in Colombia
  9. Commentary
  10. Maternal mortality due to pandemic influenza A H1N1 2009 virus in Colombia
  11. Original articles – Obstetrics
  12. The peripheral whole-blood transcriptome of acute pyelonephritis in human pregnancya
  13. Extremely short cervix in the second trimester: bed rest or modified Shirodkar cerclage?
  14. The importance of repeated measurements of the sFlt-1/PlGF ratio for the prediction of preeclampsia and intrauterine growth restriction
  15. Does the presence of thyroid antibodies affect the course and outcome of pregnancy in type 1 diabetic women?
  16. The impact of perinatal death on obstetrics nurses: a longitudinal and cross-sectional examination
  17. Effect of high-fat diet prior to pregnancy on hepatic gene expression and histology in mouse offspring
  18. The prevalence and clinical features of twin-twin transfusion syndrome with onset during the third trimester
  19. Original article – Newborn
  20. Short and medium-term outcomes of live-born twins after fetoscopic laser therapy for twin-twin transfusion syndromea
  21. Original article – Fetus
  22. Fetal volume at 11–14 gestational weeks: reference ranges and association with first trimester biochemical and biophysical markers
  23. Original articles – Newborn
  24. Resuscitation at birth in neonates with meningomyelocele
  25. Steroid profiling for congenital adrenal hyperplasia by tandem mass spectrometry as a second-tier test reduces follow-up burdens in a tertiary care hospital: A retrospective and prospective evaluation
  26. Influence of antenatal magnesium sulfate application on cord blood levels of brain-derived neurotrophic factor in premature infants
  27. Short communication
  28. Hepatitis C virus-associated thrombocytopenia in pregnancy: impact upon multidisciplinary care provision
  29. Congress Calendar
  30. Congress Calendar
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