Ablation of acardiac twin by alcohol injection into the intra-abdominal umbilical artery

Sepulveda, Waldo, Bower, Sarah, Hassan, Jamiyah and Fisk, Nicholas M. (1995) Ablation of acardiac twin by alcohol injection into the intra-abdominal umbilical artery. Obstetrics and Gynecology, 86 4: 680-681.


Author Sepulveda, Waldo
Bower, Sarah
Hassan, Jamiyah
Fisk, Nicholas M.
Title Ablation of acardiac twin by alcohol injection into the intra-abdominal umbilical artery
Journal name Obstetrics and Gynecology
Publication date 1995-10
Sub-type Article
DOI 10.1016/0029-7844(95)00171-M
Volume number 86
Issue number 4
ISSN 0029-7844;1873-233X
Start page 680
End page 681
Total pages 2
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract Background:
Twin reversed arterial perfusion sequence is a rare complication of monochorionic twinning, in which the normal pump twin perfuses the abnormal acardiac twin in a reversed fashion via an artery-to- artery placental anastomosis. Mortality in the normal twin exceeds 50% as a result of preterm labor, polyhydramnios, and congestive heart failure.

Case:
A twin pregnancy complicated by the twin reversed arterial perfusion sequence developed early hemodynamic decompensation in the pump twin with increasing size of the acardiac twin. Ablation of the acardiac twin at 25 weeks' gestation was achieved successfully by injecting 1 mL of absolute alcohol into the intra-abdominal portion of the single umbilical artery.

Conclusion:
Direct ultrasound-guided intravascular injection of absolute is an easy and straightforward technique to occlude circulation to the acardiac twin. This vessel can be identified easily by color Doppler ultrasonography away from the main venous trunk. Selection of this target, rather than occlusion at the level of the umbilical cord, could reduce the risks of cord accidents and inadvertent intravenous injection of the ablative material.
Keyword Absolute ethanol
Acephalic twin
Pregnancies
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article
Collection: Faculty of Health Sciences -- Publications
 
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