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Management of severe twin to twin transfusion syndrome

Published online by Cambridge University Press:  15 January 2010

Jon Hyett
Affiliation:
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital School of Medicine, London.
Yves Ville
Affiliation:
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital School of Medicine, London.
Neil Sebire
Affiliation:
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital School of Medicine, London.
Waldo Sepulveda
Affiliation:
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital School of Medicine, London.
Kypros Nicolaides*
Affiliation:
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital School of Medicine, London.
*
Professor KH Nicolaides, Harris Birthright Research Centre for Fetal Medicine, Kings College Hospital School of Medicine, London SE5 8RX

Extract

In monozygotic twin pregnancies embryonic splitting within three days of fertilisation, which occurs in approximately one-third of cases, results in two separate fetuses with independent placental circulations. Splitting after the third day of fertilisation is associated with vascular communications between the placentae; when cleavage is delayed beyond day 12 the fetuses are conjoint. In some monochorionic twin pregnancies imbalance in the net flow of blood across the placental vascular communications from one fetus (the donor) to the other (the recipient) results in twin to twin transfusion syndrome (TTS).

Type
Research Article
Copyright
Copyright © Cambridge University Press 1996

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