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Monochorionic twin pregnancy: screening, pathogenesis of complications and management in the era of microinvasive fetal surgery
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Michael Tchirikov
Veröffentlicht/Copyright:
14. Juli 2010
Abstract
Objective: The management of monochorionic (MC) twin pregnancies varies in different medical centers. This paper compares screening methods to predict the complications of the MC twin pregnancy and different treatment methods.
Methods: We performed a literature search without language restriction in Cochrane library and PubMed (1970–2009). Case series and cohort screening studies, pathogenesis and management of complications of MC pregnancy were included.
Results: Elevated risk for intrauterine fetal death (IUFD) and twin-to-twin transfusion syndrome (TTTS) can be detected sonographically. Monitoring of MC pregnancies at increased risk and regular training sessions for the operating team combined with reduced fetoscopic amniotic membrane damage increase fetal survival rate from laser coagulation to nearly 100% for at least one fetus and to 90% for both.
Conclusion: Monitoring of MC pregnancies at increased risk and laser treatment of TTTS in medical centers with sufficient experience might improve neonatal outcome.
Received: 2009-9-23
Revised: 2010-1-12
Accepted: 2010-2-5
Published Online: 2010-07-14
Published Online: 2010-07-14
Published in Print: 2010-09-01
©2010 by Walter de Gruyter Berlin New York
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Artikel in diesem Heft
- Review article
- Monochorionic twin pregnancy: screening, pathogenesis of complications and management in the era of microinvasive fetal surgery
- Original articles – Obstetrics
- Longitudinal examination of cervical volume and vascularization changes during the antepartum and postpartum period using three-dimensional and power Doppler ultrasound
- Uterine and umbilical artery Doppler velocimetry as a predictor for adverse pregnancy outcomes in pregnant women with anemia
- Prooxidant-antioxidant balance in pregnancy: a randomized double-blind placebo-controlled trial of selenium supplementation
- Two-stage transvaginal cervical length screening for preterm birth in twin pregnancies
- The relationship between placental histology and cervical length in twin gestations
- A novel method for evaluating uterine cervical consistency using vaginal ultrasound gray-level histogram
- Microbial invasion of the amniotic cavity in pregnancies with small-for-gestational-age fetuses
- Microbial invasion of the amniotic cavity in preeclampsia as assessed by cultivation and sequence-based methods
- Original articles – Fetus
- Perinatal exposure to di-(2-ethylhexyl) phthalate leads to restricted growth and delayed lung maturation in newborn rats
- Calprotectin in human cord blood: relation to perinatal parameters and restricted fetal growth
- Original articles – Newborn
- Diagnostic value of interleukin-6 and C-reactive protein on early onset bacterial infection in preterm neonates with respiratory distress
- Simulated transport alters surfactant homeostasis and causes dose-dependent changes in respiratory function in neonatal Sprague-Dawley rats
- Early protective effect of hypothermia in newborn pigs after hyperoxic, but not after normoxic, reoxygenation
- Surfactant administration for neonatal respiratory distress does not improve lung interstitial fluid clearance: echographic and experimental evidence
- Letter to the editor
- Double aneuploidy of trisomy 18 and Klinefelter syndrome: prenatal diagnosis and perinatal outcome
- Congress Calender
- Congress Calendar
Schlagwörter für diesen Artikel
IUGR;
laser coagulation;
monochorionic pregnancy;
outcome;
treatment;
TTTS
Artikel in diesem Heft
- Review article
- Monochorionic twin pregnancy: screening, pathogenesis of complications and management in the era of microinvasive fetal surgery
- Original articles – Obstetrics
- Longitudinal examination of cervical volume and vascularization changes during the antepartum and postpartum period using three-dimensional and power Doppler ultrasound
- Uterine and umbilical artery Doppler velocimetry as a predictor for adverse pregnancy outcomes in pregnant women with anemia
- Prooxidant-antioxidant balance in pregnancy: a randomized double-blind placebo-controlled trial of selenium supplementation
- Two-stage transvaginal cervical length screening for preterm birth in twin pregnancies
- The relationship between placental histology and cervical length in twin gestations
- A novel method for evaluating uterine cervical consistency using vaginal ultrasound gray-level histogram
- Microbial invasion of the amniotic cavity in pregnancies with small-for-gestational-age fetuses
- Microbial invasion of the amniotic cavity in preeclampsia as assessed by cultivation and sequence-based methods
- Original articles – Fetus
- Perinatal exposure to di-(2-ethylhexyl) phthalate leads to restricted growth and delayed lung maturation in newborn rats
- Calprotectin in human cord blood: relation to perinatal parameters and restricted fetal growth
- Original articles – Newborn
- Diagnostic value of interleukin-6 and C-reactive protein on early onset bacterial infection in preterm neonates with respiratory distress
- Simulated transport alters surfactant homeostasis and causes dose-dependent changes in respiratory function in neonatal Sprague-Dawley rats
- Early protective effect of hypothermia in newborn pigs after hyperoxic, but not after normoxic, reoxygenation
- Surfactant administration for neonatal respiratory distress does not improve lung interstitial fluid clearance: echographic and experimental evidence
- Letter to the editor
- Double aneuploidy of trisomy 18 and Klinefelter syndrome: prenatal diagnosis and perinatal outcome
- Congress Calender
- Congress Calendar
