Characterisation of deep arterio-venous anastomoses within monochorionic placentae by vascular casting

Wee, L. Y., Taylor, M., Watkins, N., Franke, V., Parker, K. and Fisk, N. M. (2005) Characterisation of deep arterio-venous anastomoses within monochorionic placentae by vascular casting. Placenta, 26 1: 19-24. doi:10.1016/j.placenta.2004.04.007


Author Wee, L. Y.
Taylor, M.
Watkins, N.
Franke, V.
Parker, K.
Fisk, N. M.
Title Characterisation of deep arterio-venous anastomoses within monochorionic placentae by vascular casting
Journal name Placenta   Check publisher's open access policy
ISSN 0143-4004
1532-3102
0265-7023
Publication date 2005-01-01
Year available 2005
Sub-type Article (original research)
DOI 10.1016/j.placenta.2004.04.007
Open Access Status Not yet assessed
Volume 26
Issue 1
Start page 19
End page 24
Total pages 6
Place of publication London, U.K.
Publisher W B Saunders
Language eng
Subject 111401 Foetal Development and Medicine
111402 Obstetrics and Gynaecology
1114 Paediatrics and Reproductive Medicine
Abstract Objective: To characterise arterio-venous anastomoses (AVA) in monochorionic (MC) placentae and determine (i) whether shared cotyledons lie beneath the co-termination of an artery from one twin and a vein to the contralateral twin and (ii) whether all AVA can be detected by visual inspection of the chorionic plate.
Formatted abstract
Objectives: To characterise arterio-venous anastomoses (AVA) in monochorionic (MC) placentae and determine (i) whether shared cotyledons lie beneath the co-termination of an artery from one twin and a vein to the contralateral twin and (ii) whether all AVA can be detected by visual inspection of the chorionic plate.
Methods: Vascular casts were made of 15 MC placentae. The number of typical AVAs suspected visually before digestion was compared with the number of AVAs identified after acid digestion.
Results: Thirty-three of 67 (49%) suspected typical AVAs were confirmed as typical after casting. There were five false positives and no false negatives. The remainder were classified as atypical AVAs, found in ≥90% of MC placentae. Type I (small vascular connections between two apparently normal cotyledons not seen before casting) and Type II (shared cotyledons arising within larger apparently normal cotyledons) atypical AVAs were found in 53% and 73% of placentae, respectively.
Conclusions: Only half the shared cotyledons in MC placentae are characterised by co-termination of an artery and vein on the chorionic plate. We report the existence of deep anastomoses beneath the chorionic plate that cannot be visualised by chorionic plate inspection. These findings have implications for laser treatment of twin–twin transfusion syndrome.
©2004 Elsevier Ltd. All rights reserved.

Keyword Arterio-arterial anastomoses
Monochorionic placentae
Shared cotyledons
Twin-twin transfusion 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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