Reversal of twin-twin transfusion syndrome: Frequency, vascular anatomy, associated anomalies and outcome

Wee, Ling Y., Taylor, Myles J. O., Vanderheyden, Tina, Wimalasundera, Ruwan, Gardiner, Helena M. and Fisk, Nicholas M. (2004) Reversal of twin-twin transfusion syndrome: Frequency, vascular anatomy, associated anomalies and outcome. Prenatal Diagnosis, 24 2: 104-110. doi:10.1002/pd.799


Author Wee, Ling Y.
Taylor, Myles J. O.
Vanderheyden, Tina
Wimalasundera, Ruwan
Gardiner, Helena M.
Fisk, Nicholas M.
Title Reversal of twin-twin transfusion syndrome: Frequency, vascular anatomy, associated anomalies and outcome
Journal name Prenatal Diagnosis   Check publisher's open access policy
ISSN 1097-3851; 1097-0223
Publication date 2004-03-01
Year available 2004
Sub-type Article (original research)
DOI 10.1002/pd.799
Open Access Status
Volume 24
Issue 2
Start page 104
End page 110
Total pages 7
Editor D. W. Bianchi
Place of publication Chichester, U.K.
Publisher Wiley
Language eng
Subject 111401 Foetal Development and Medicine
1103 Clinical Sciences
1114 Paediatrics and Reproductive Medicine
Abstract Objective To determine the frequency of reversal of transfusional gradient and phenotype in a large cohort of prospectively studied cases of twin-twin transfusion syndrome (TTTS) and seek evidence of clinical or placental anastomotic associations.
Formatted abstract
Objective: To determine the frequency of reversal of transfusional gradient and phenotype in a large cohort of prospectively studied cases of twin-twin transfusion syndrome (TTTS) and seek evidence of clinical or placental anastomotic associations.
Methods: Consecutive cases of TTTS seen over an eight-year period with serial documentation of ultrasonic growth, liquor volume and fetal and placental Doppler studies were reviewed. Postnatal injection studies were inspected.
Results: Reversal of TTTS occurred in 5 of 96 affected pregnancies (5%). Two of the five cases had underlying aneuploidy or genetic syndrome, higher than the 2% frequency found in cases without reversal of TTTS (p < 0.05). Placental anastomotic configurations provided no consistent explanation for reversal of phenotype.
Conclusion: This study documents the frequency of reversal of the direction of TTTS, and suggests that it is a heterogeneous condition. Reversal of donor-recipient phenotype may be explained by haemodynamic changes secondary to underlying aneuploidy/genetic syndromes, to the presence of multiple anastomoses in either direction or following laser ablation. This series together with previous case reports argues for a high level of suspicion for underlying aneuploidy, genetic syndrome or structural defects where there is reversal of the donor-recipient phenotype.
Copyright © 2004 John Wiley & Sons, Ltd
Keyword Monochorionic twins
Reversal of twin-twin transfusion syndrome
Structural anomalies
Aneuploidy and genetic syndrome
Q-Index Code C1
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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