Book contents
- Anesthesia for Maternal-Fetal Surgery
- Anesthesia for Maternal-Fetal Surgery
- Copyright page
- Dedication
- Contents
- Contributors
- Abbreviations
- Preface
- Acknowledgments
- Section 1
- Section 2
- Chapter 6 Twin-Twin Transfusion Syndrome
- Chapter 7 Fetal Endoscopic Tracheal Occlusion (FETO)
- Chapter 8 Fetal Cardiac Intervention
- Chapter 9 Antepartum Fetal Monitoring
- Section 3
- Index
- Endmatter
- References
Chapter 6 - Twin-Twin Transfusion Syndrome
from Section 2
Published online by Cambridge University Press: 19 November 2021
Edited by
Book contents
- Anesthesia for Maternal-Fetal Surgery
- Anesthesia for Maternal-Fetal Surgery
- Copyright page
- Dedication
- Contents
- Contributors
- Abbreviations
- Preface
- Acknowledgments
- Section 1
- Section 2
- Chapter 6 Twin-Twin Transfusion Syndrome
- Chapter 7 Fetal Endoscopic Tracheal Occlusion (FETO)
- Chapter 8 Fetal Cardiac Intervention
- Chapter 9 Antepartum Fetal Monitoring
- Section 3
- Index
- Endmatter
- References
Summary
Twin pregnancies, especially those in which the twins share one placenta but have separate amnion sacs (referred to monochorionic, diamniotic or Mo-di twins), are at risk for a number of complications. Most notable of these is twin-twin transfusion syndrome. This condition can result in fetal morbidity or intrauterine fetal demise but is also amenable to surgical intervention. Severe discordance in amniotic fluid volumes between each twin is the prenatal finding that highlights this diagnosis. Selective laser photocoagulation has greatly improved the survival of twins with this condition. With a posteriorly located placenta, laser ablation of the abnormal placenta vascular communications can be achieved with local anesthesia and maternal sedation. Anterior placenta location may present a challenge for uterine access that may require modification of the anesthetic technique.
Keywords
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- Information
- Anesthesia for Maternal-Fetal SurgeryConcepts and Clinical Practice, pp. 83 - 94Publisher: Cambridge University PressPrint publication year: 2021
References
Faye-Peterson, O, Crombleholme, T. Twin-twin transfusion: part 2: infant anomalies, clinical intervention and placental examination. Neoreviews. 2008;9(9):e380.Google Scholar
Bamberg, C, Hecher, K. Update on twin-to-twin transfusion syndrome. Best Pract Res Clin Obstet Gynaecol. 2019;58:55–65.Google Scholar
Society for Maternal-Fetal Medicine, Simpson LL. Twin-twin transfusion syndrome. Am J Obstet Gynecol. 2013;208(1):3–18.CrossRefGoogle Scholar
Michelfelder, E, Gottliebson, W, Border, W, et al. Early manifestations and spectrum of recipient twin cardiomyopathy in twin-twin transfusion syndrome: relation to Quintero stage. Ultrasound Obstet Gynecol. 2007;30(7):965–971.Google Scholar
Johnson, A. Diagnosis and management of twin-twin transfusion syndrome. Clin Obstet Gynecol. 2015;58(3):611–631.CrossRefGoogle ScholarPubMed
Quintero, RA, Morales, WJ, Allen, MH, et al. Staging of twin-twin transfusion syndrome. J Perinatol. 1999; 19(8 Pt 1):550–555.CrossRefGoogle ScholarPubMed
Khalil, A, Rodgers, M, Baschat, A, et al. ISUOG Practice Guidelines: role of ultrasound in twin pregnancy. Ultrasound Obstet Gynecol. 2016;47(2):247–263.Google Scholar
Oepkes, D, Sueters, M. Antenatal fetal surveillance in multiple pregnancies. Best Pract Res Clin Obstet Gynaecol. 2017;38:59–70.CrossRefGoogle ScholarPubMed
Stagnati, V, Zanardini, C, Fichera, A, et al. Early prediction of twin-to-twin transfusion syndrome: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2017;49(5):573–582.Google Scholar
Senat, MV, Deprest, J, Boulvain, M, et al. Endoscopic laser surgery versus serial amnioreduction for severe twin-to-twin transfusion syndrome. N Engl J Med. 2004;351(2):136–144.Google Scholar
Salomon, LJ, Ortqvist, L, Aegerter, P, et al. Long-term developmental follow-up of infants who participated in a randomized clinical trial of amniocentesis vs laser photocoagulation for the treatment of twin-to-twin transfusion syndrome. Am J Obstet Gynecol. 2010;203(5):444.e1–444.e7.Google Scholar
Ville, Y, Hyett, J, Hecher, K, Nicolaides, K. Preliminary experience with endoscopic laser surgery for severe twin-twin transfusion syndrome. N Engl J Med. 1995;332(4):224–227.Google Scholar
Slaghekke, F, Oepkes, D. Solomon technique versus selective coagulation for twin-twin transfusion. Twin Research Hum Genet. 2016;19(3):217–221.Google Scholar
Quintero, RA, Comas, C, Bornick, PW, et al. Selective versus non-selective laser photocoagulation of placental vessels in twin-to-twin transfusion syndrome. Ultrasound Obstet Gynecol. 2000;16(3):230–236.Google Scholar
Ngamprasertwong, P, Habli, M, Boat, A, et al. Maternal hypotension during fetoscopic surgery: incidence and its impact on fetal survival outcomes. ScientificWorldJournal. 2013;2013:709059.Google Scholar
Van Mieghem, T, Klaritsch, P, Done, E, et al. Assessment of fetal cardiac function before and after therapy for twin-to-twin transfusion syndrome. Am J Obstet Gynecol. 2009;200(4):400.e1–400.e7.Google Scholar
Lopriore, E, Middeldorp, JM, Oepkes, D, Klumper, FJ, Walther, FJ, Vandenbussche, FP. Residual anastomoses after fetoscopic laser surgery in twin-to-twin transfusion syndrome: frequency, associated risks and outcome. Placenta. 2007; 28(2-3):204–208.Google Scholar
Gupta, R, Kilby, M, Cooper, G. Fetal surgery and anaesthetic implications. BJA Educ. 2008;8(2):71–75.Google Scholar
Rossi, AC, Kaufman, MA, Bornick, PW, Quintero, RA. General vs local anesthesia for the percutaneous laser treatment of twin-twin transfusion syndrome. Am J Obstet Gynecol. 2008;199(2):137.e1–137.e7.CrossRefGoogle ScholarPubMed
Lewi, L, Jani, J, Blickstein, I, et al. The outcome of monochorionic diamniotic twin gestations in the era of invasive fetal therapy: a prospective cohort study. Am J Obstet Gynecol. 2008;199(5):514.e1–514.e8.Google Scholar
Slaghekke, F, Zhao, DP, Middeldorp, JM, et al. Antenatal management of twin-twin transfusion syndrome and twin anemia-polycythemia sequence. Expert Rev Hematol. 2016;9(8):815–820.CrossRefGoogle ScholarPubMed
Van de Velde, M, Van Schoubroeck, D, Lewi, LE, et al. Remifentanil for fetal immobilization and maternal sedation during fetoscopic surgery: a randomized, double-blind comparison with diazepam. Anesth Analg. 2005;101(1):251–258.Google Scholar
Middeldorp, JM, Lopriore, E, Sueters, M, et al. Laparoscopically guided uterine entry for fetoscopy in twin-to-twin transfusion syndrome with completely anterior placenta: a novel technique. Fetal Diagn Ther. 2007;22(6):409–415.Google Scholar
Papanna, R, Johnson, A, Ivey, RT, et al. Laparoscopy-assisted fetoscopy for laser surgery in twin-twin transfusion syndrome with anterior placentation. Ultrasound Obstet Gynecol. 2010;35:65–70.Google Scholar
Shamshirsaz, AA, Javadian, P, Ruano, R, et al. Comparison between laparoscopically assisted and standard fetoscopic laser ablation in patients with anterior and posterior placentation in twin-twin transfusion syndrome: a single center study. Prenat Diagn. 2015;35(4):376–381.Google Scholar