Placenta
Volume 30, Issue 5 , Pages 379-390 , May 2009

The Basic and Clinical Science of Twin–Twin Transfusion Syndrome

  • N.M. Fisk

      Affiliations

    • The University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia
    • Centre for Advanced Prenatal Care, Royal Brisbane and Women's Hospital, Brisbane, Australia
    • Corresponding Author InformationCorrespondence to: Prof. N.M. Fisk, Director, UQ Centre for Clinical Research, RBWH Campus, Herston 4029, Qld, Australia. Tel.: +61 7 33465500; fax: +61 7 3346 5509.
    • ,
  • G.J. Duncombe

      Affiliations

    • Centre for Advanced Prenatal Care, Royal Brisbane and Women's Hospital, Brisbane, Australia
    • ,
  • M.H.F. Sullivan

      Affiliations

    • Department of Reproductive Biology, Institute of Reproductive & Developmental Biology, Wolfson & Weston Centre for Family Research, Imperial College London, London, United Kingdom

,Accepted 23 February 2009.

References 

  1. Duncan KR, Denbow M, Fisk NM. The aetiology and management of twin–twin transfusion syndrome. Prenat Diagn. 1997;17:1227–1236
  2. Lewi L, Jani J, Blickstein I, Huber A, Gucciardo L, Van Mieghem T, 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(514):e1–e8
  3. Denbow ML, Cox P, Taylor M, Hammal DM, Fisk NM. Placental angioarchitecture in monochorionic twin pregnancies: relationship to fetal growth, fetofetal transfusion syndrome, and pregnancy outcome. Am J Obstet Gynecol. 2000;182:417–426
  4. Wee L, Taylor M, Watkins N, Franke V, Parker K, Fisk NM. Characterisation of deep arterio-venous anastomoses within monochorionic placentae by vascular casting. Placenta. 2005;26:19–24
  5. Hack KE, Nikkels PG, Koopman-Esseboom C, Derks JB, Elias SG, van Gemert MJ, et al. Placental characteristics of monochorionic diamniotic twin pregnancies in relation to perinatal outcome. Placenta. 2008;29:976–981
  6. Galea P, Jain V, Fisk NM. Insights into the pathophysiology of twin–twin transfusion syndrome. Prenat Diagn. 2005;25:777–785
  7. van den Wijngaard JP, Umur A, Ross MG, van Gemert MJ. Twin–twin transfusion syndrome: mathematical modelling. Prenat Diagn. 2008;28:280–291
  8. Senat MV, Deprest J, Boulvain M, Paupe A, Winer N, Ville Y. Endoscopic laser surgery versus serial amnioreduction for severe twin-to-twin transfusion syndrome. N Engl J Med. 2004;351:136–144
  9. Roberts D, Gates S, Kilby M, Neilson JP. Interventions for twin–twin transfusion syndrome: a Cochrane review. Ultrasound Obstet Gynecol. 2008;31:701–711
  10. Yamamoto M, Essaoui M, Nasr B, Malek N, Takahashi Y, Moreira de Sa R, et al. Three-dimensional sonographic assessment of fetal urine production before and after laser surgery in twin-to-twin transfusion syndrome. Ultrasound Obstet Gynecol. 2007;30:972–976
  11. Quintero RA, Chmait RH, Carver J, Bornick PW, Allen MH, Kontopoulos EV. In utero fetal oximetry via visible light spectroscopy in twin–twin transfusion syndrome. Am J Obstet Gynecol. 2008;199(639):e1–e4
  12. Cheung YF, Taylor MJ, Fisk NM, Redington AN, Gardiner HM. Fetal origins of reduced arterial distensibility in the donor twin in twin–twin transfusion syndrome. Lancet. 2000;355:1157–1158
  13. Gardiner HM, Taylor MJ, Karatza A, Vanderheyden T, Huber A, Greenwald SE, et al. Twin–twin transfusion syndrome: the influence of intrauterine laser photocoagulation on arterial distensibility in childhood. Circulation. 2003;107:1906–1911
  14. Lewi L, Gucciardo L, Huber A, Jani J, Van Mieghem T, Done E, et al. Clinical outcome and placental characteristics of monochorionic diamniotic twin pairs with early- and late-onset discordant growth. Am J Obstet Gynecol. 2008;199(511):e1–e7
  15. Lopriore E, Deprest J, Slaghekke F, Oepkes D, Middeldorp JM, Vandenbussche FP, et al. Placental characteristics in monochorionic twins with and without twin anemia-polycythemia sequence. Obstet Gynecol. 2008;112:753–758
  16. Barigye O, Pasquini L, Galea P, Chambers H, Chappell L, Fisk NM. High risk of unexpected late fetal death in monochorionic twins despite intensive ultrasound surveillance: a cohort study. PLoS Med. 2005;2:521–527
  17. Hack KE, Derks JB, Elias SG, Franx A, Roos EJ, Voerman SK, et al. Increased perinatal mortality and morbidity in monochorionic versus dichorionic twin pregnancies: clinical implications of a large Dutch cohort study. BJOG. 2008;115:58–67
  18. Sebire NJ, Talbert D, Fisk NM. Twin-to-twin transfusion syndrome results from dynamic asymmetrical reduction in placental anastomoses: a hypothesis. Placenta. 2001;22:383–391
  19. Taylor MJ, Denbow ML, Tanawattanacharoen S, Gannon C, Cox PM, Fisk NM. Doppler detection of arterio-arterial anastomoses in monochorionic twins: feasibility and clinical application. Hum Reprod. 2000;15:1632–1636
  20. Kagan KO, Gazzoni A, Sepulveda-Gonzalez G, Sotiriadis A, Nicolaides KH. Discordance in nuchal translucency thickness in the prediction of severe twin-to-twin transfusion syndrome. Ultrasound Obstet Gynecol. 2007;29:527–532
  21. Wee LY, Taylor MJ, Vanderheyden T, Wimalasundera R, Gardiner HM, Fisk NM. Reversal of twin–twin transfusion syndrome: frequency, vascular anatomy, associated anomalies and outcome. Prenat Diagn. 2004;24:104–110
  22. Robyr R, Lewi L, Salomon LJ, Yamamoto M, Bernard JP, Deprest J, et al. Prevalence and management of late fetal complications following successful selective laser coagulation of chorionic plate anastomoses in twin-to-twin transfusion syndrome. Am J Obstet Gynecol. 2006;194:796–803
  23. Crombleholme TM, Shera D, Lee H, Johnson M, D'Alton M, Porter F, et al. A prospective, randomized, multicenter trial of amnioreduction vs selective fetoscopic laser photocoagulation for the treatment of severe twin–twin transfusion syndrome. Am J Obstet Gynecol. 2007;197(396):e1–e9
  24. O'Donoghue K, Cartwright E, Galea P, Fisk NM. Stage I twin–twin transfusion syndrome: rates of progression and regression in relation to outcome. Ultrasound Obstet Gynecol. 2007;30:958–964
  25. Huber A, Diehl W, Bregenzer T, Hackeloer BJ, Hecher K. Stage-related outcome in twin–twin transfusion syndrome treated by fetoscopic laser coagulation. Obstet Gynecol. 2006;108:333–337
  26. Graef C, Ellenrieder B, Hecher K, Hackeloer BJ, Huber A, Bartmann P. Long-term neurodevelopmental outcome of 167 children after intrauterine laser treatment for severe twin–twin transfusion syndrome. Am J Obstet Gynecol. 2006;194:303–308
  27. Quintero RA, Morales WJ, Allen MH, Bornick PW, Johnson PK, Kruger M. Staging of twin–twin transfusion syndrome. J Perinatol. 1999;19:550–555
  28. Taylor MJ, Govender L, Jolly M, Wee L, Fisk NM. Validation of the Quintero staging system for twin–twin transfusion syndrome. Obstet Gynecol. 2002;100:1257–1265
  29. Duncombe GJ, Dickinson JE, Evans SF. Perinatal characteristics and outcomes of pregnancies complicated by twin–twin transfusion syndrome. Obstet Gynecol. 2003;101:1190–1196
  30. Nikkels PG, Hack KE, van Gemert MJ. Pathology of twin placentas with special attention to monochorionic twin placentas. J Clin Pathol. 2008;61:1247–1253
  31. Fisk NM, Borrell A, Hubinont C, Tannirandorn Y, Nicolini U, Rodeck CH. Fetofetal transfusion syndrome: do the neonatal criteria apply in utero?. Arch Dis Child. 1990;65:657–661
  32. Denbow ML, Welsh AW, Taylor MJ, Blomley MJ, Cosgrove DO, Fisk NM. Twin fetuses: intravascular microbubble US contrast agent administration – early experience. Radiology. 2000;214:724–728
  33. Tan TY, Taylor MJ, Wee LY, Vanderheyden T, Wimalasundera R, Fisk NM. Doppler for artery–artery anastomosis and stage-independent survival in twin–twin transfusion. Obstet Gynecol. 2004;103:1174–1180
  34. Tan T, Denbow ML, Cox PM, Talbert D, Fisk NM. Thrombosis of arterio-arterial anastomosis manifesting as acute twin–twin tranfusion syndrome. Placenta. 2004;25:238–242
  35. Bermudez C, Becerra CH, Bornick PW, Allen MH, Arroyo J, Quintero RA. Placental types and twin–twin transfusion syndrome. Am J Obstet Gynecol. 2002;187:489–494
  36. Diehl W, Hecher K, Zikulnig L, Vetter M, Hackeloer BJ. Placental vascular anastomoses visualized during fetoscopic laser surgery in severe mid-trimester twin–twin transfusion syndrome. Placenta. 2001;22:876–881
  37. Murakoshi T, Quintero RA, Bornick PW, Allen MH. In vivo endoscopic assessment of arterioarterial anastomoses: insight into their hemodynamic function. J Matern Fetal Neonatal Med. 2003;14:247–255
  38. Taylor MJ, Talbert D, Fisk NM. Pseudo-arterio-arterial anastomoses in twin–twin transfusion syndrome. Placenta. 2004;25:742–747discussion 8–52
  39. Lewi L, Jani J, Cannie M, Robyr R, Ville Y, Hecher K, et al. Intertwin anastomoses in monochorionic placentas after fetoscopic laser coagulation for twin-to-twin transfusion syndrome: is there more than meets the eye?. Am J Obstet Gynecol. 2006;194:790–795
  40. van den Wijngaard JP, Lopriore E, van der Salm SM, Schaap AH, Vandenbussche FP, Deruiter MC, et al. Deep-hidden anastomoses in monochorionic twin placentae are harmless. Prenat Diagn. 2007;27:233–239
  41. Kaufmann P, Mayhew TM, Charnock-Jones DS. Aspects of human fetoplacental vasculogenesis and angiogenesis. II. Changes during normal pregnancy. Placenta. 2004;25:114–126
  42. le Noble F, Moyon D, Pardanaud L, Yuan L, Djonov V, Matthijsen R, et al. Flow regulates arterial-venous differentiation in the chick embryo yolk sac. Development (Cambridge, England). 2004;131:361–375
  43. Kumazaki K, Nakayama M, Suehara N, Wada Y. Expression of vascular endothelial growth factor, placental growth factor, and their receptors Flt-1 and KDR in human placenta under pathologic conditions. Hum Pathol. 2002;33:1069–1077
  44. Nevo O, Many A, Xu J, Kingdom J, Piccoli E, Zamudio S, et al. Placental expression of soluble fms-like tyrosine kinase 1 is increased in singletons and twin pregnancies with intrauterine growth restriction. J Clin Endocrinol Metab. 2008;93:285–292
  45. Kusanovic JP, Romero R, Espinoza J, Nien JK, Kim CJ, Mittal P, et al. Twin-to-twin transfusion syndrome: an antiangiogenic state?. Am J Obstet Gynecol. 2008;198(382):e1–e8
  46. Galea P, Barigye O, Wee L, Jain V, Sullivan M, Fisk N. The placenta contributes to activation of the renin angiotensin system in twin–twin transfusion syndrome. Placenta. 2008;29:734–742
  47. Bajoria R. Abundant vascular anastomoses in monoamniotic versus diamniotic monochorionic placentas. Am J Obstet Gynecol. 1998;179:788–793
  48. Denbow ML, Taylor M, Cox P, Fisk NM. Derivation of rate of arterio-arterial anastomotic transfusion between monochorionic twin fetuses by Doppler waveform analysis. Placenta. 2004;25:664–670
  49. Lopriore E, Van den Wijngaard JP, Pasman SA, Oepkes D, Walther FJ, Van Gemert MJ, et al. Quantification of feto-fetal transfusion rate through a single placental arterio-venous anastomosis in a monochorionic twin pregnancy. Placenta. 2009;30:223–225
  50. Taylor MJ, Farquharson D, Cox PM, Fisk NM. Identification of arterio-venous anastomoses in vivo in monochorionic twin pregnancies: preliminary report. Ultrasound Obstet Gynecol. 2000;16:218–222
  51. Wee LY, Sebire NJ, Bhundia J, Sullivan M, Fisk NM. Histomorphometric characterisation of shared and non-shared cotyledonary villus territories of monochorionic placentae in relation to pregnancy complications. Placenta. 2006;27:475–482
  52. Nakata M, Martinez JM, Diaz C, Chmait R, Quintero RA. Intra-amniotic Doppler measurement of blood flow in placental vascular anastomoses in twin–twin transfusion syndrome. Ultrasound Obstet Gynecol. 2004;24:102–103
  53. Umur A, van Gemert MJ, Nikkels PG. Monoamniotic-versus diamniotic-monochorionic twin placentas: anastomoses and twin–twin transfusion syndrome. Am J Obstet Gynecol. 2003;189:1325–1329
  54. Heyborne KD, Porreco RP, Garite TJ, Phair K, Abril D. Improved perinatal survival of monoamniotic twins with intensive inpatient monitoring. Am J Obstet Gynecol. 2005;192:96–101
  55. Hack KE, van Gemert MJ, Lopriore E, Schaap AH, Eggink AJ, Elias SG, et al. Placental characteristics of monoamniotic twin pregnancies in relation to perinatal outcome. Placenta. 2009;30:62–65
  56. Pasquini L, Wimalasundera RC, Fichera A, Barigye O, Chappell L, Fisk NM. High perinatal survival in monoamniotic twins managed by prophylactic sulindac, intensive ultrasound surveillance, and Cesarean delivery at 32 weeks' gestation. Ultrasound Obstet Gynecol. 2006;28:681–687
  57. Lopriore E, Middeldorp JM, Oepkes D, Kanhai HH, Walther FJ, Vandenbussche FP. Twin anemia–polycythemia sequence in two monochorionic twin pairs without oligo-polyhydramnios sequence. Placenta. 2007;28:47–51
  58. Bajoria R, Ward S, Chatterjee R. Natriuretic peptides in the pathogenesis of cardiac dysfunction in the recipient fetus of twin–twin transfusion syndrome. Am J Obstet Gynecol. 2002;186:121–127
  59. Bajoria R, Ward S, Chatterjee R. Brain natriuretic peptide and endothelin-1 in the pathogenesis of polyhydramnios–oligohydramnios in monochorionic twins. Am J Obstet Gynecol. 2003;189:189–194
  60. Bajoria R, Ward S, Sooranna SR. Atrial natriuretic peptide mediated polyuria: pathogenesis of polyhydramnios in the recipient twin of twin–twin transfusion syndrome. Placenta. 2001;22:716–724
  61. Bajoria R, Ward S, Sooranna SR. Influence of vasopressin in the pathogenesis of oligohydramnios–polyhydramnios in monochorionic twins. Eur J Obstet Gynecol Reprod Biol. 2004;113:49–55
  62. Oberg KC, Pestaner JP, Bielamowicz L, Hawkins EP. Renal tubular dysgenesis in twin–twin transfusion syndrome. Pediatr Dev Pathol. 1999;2:25–32
  63. Cincotta RB, Gray PH, Phythian G, Rogers YM, Chan FY. Long term outcome of twin–twin transfusion syndrome. Arch Dis Child Fetal Neonatal Ed. 2000;83:F171–F176
  64. Gratacos E, Van Schoubroeck D, Carreras E, Devlieger R, Roma E, Cabero L, et al. Impact of laser coagulation in severe twin–twin transfusion syndrome on fetal Doppler indices and venous blood flow volume. Ultrasound Obstet Gynecol. 2002;20:125–130
  65. Ishii K, Chmait RH, Martinez JM, Nakata M, Quintero RA. Ultrasound assessment of venous blood flow before and after laser therapy: approach to understanding the pathophysiology of twin–twin transfusion syndrome. Ultrasound Obstet Gynecol. 2004;24:164–168
  66. Yamamoto M, Nasr B, Ortqvist L, Bernard JP, Takahashi Y, Ville Y. Intertwin discordance in umbilical venous volume flow: a reflection of blood volume imbalance in twin-to-twin transfusion syndrome. Ultrasound Obstet Gynecol. 2007;29:317–320
  67. Gungor S, Glosemeyer P, Huber A, Hecher K, Baschat AA. Umbilical venous volume flow in twin–twin transfusion syndrome. Ultrasound Obstet Gynecol. 2008;32:800–806
  68. Habli M, Michelfelder E, Livingston J, Harmon J, Lim FY, Polzin W, et al. Acute effects of selective fetoscopic laser photocoagulation on recipient cardiac function in twin–twin transfusion syndrome. Am J Obstet Gynecol. 2008;199(412):e1–e6
  69. Zikulnig L, Hecher K, Bregenzer T, Baz E, Hackeloer BJ. Prognostic factors in severe twin–twin transfusion syndrome treated by endoscopic laser surgery. Ultrasound Obstet Gynecol. 1999;14:380–387
  70. Michelfelder E, Gottliebson W, Border W, Kinsel M, Polzin W, Livingston J, et al. Early manifestations and spectrum of recipient twin cardiomyopathy in twin–twin transfusion syndrome: relation to Quintero stage. Ultrasound Obstet Gynecol. 2007;30:965–971
  71. Barrea C, Alkazaleh F, Ryan G, McCrindle BW, Roberts A, Bigras JL, et al. Prenatal cardiovascular manifestations in the twin-to-twin transfusion syndrome recipients and the impact of therapeutic amnioreduction. Am J Obstet Gynecol. 2005;192:892–902
  72. Barrea C, Hornberger LK, Alkazaleh F, McCrindle BW, Roberts A, Berezovska O, et al. Impact of selective laser ablation of placental anastomoses on the cardiovascular pathology of the recipient twin in severe twin–twin transfusion syndrome. Am J Obstet Gynecol. 2006;195:1388–1395
  73. Karatza AA, Wolfenden JL, Taylor MJ, Wee L, Fisk NM, Gardiner HM. Influence of twin–twin transfusion syndrome on fetal cardiovascular structure and function: prospective case–control study of 136 monochorionic twin pregnancies. Heart. 2002;88:271–277
  74. Denbow M, Fogliani R, Kyle P, Letsky E, Nicolini U, Fisk N. Haematological indices at fetal blood sampling in monochorionic pregnancies complicated by feto-fetal transfusion syndrome. Prenat Diagn. 1998;18:941–946
  75. Larrabee PB, Johnson KL, Pestova E, Lucas M, Wilber K, LeShane ES, et al. Microarray analysis of cell-free fetal DNA in amniotic fluid: a prenatal molecular karyotype. Am J Hum Genet. 2004;75:485–491
  76. Talbert D, Bajoria R, Sepulveda W, Bower S, Fisk N. Hydrostatic and osmotic pressure gradients produce manifestations of fetofetal transfusion syndrome in a computerised model of monochorionial twin pregnancy. Am J Obstet Gynecol. 1996;174:598–608
  77. Umur A, van Gemert MJ, Nikkels PG, Ross MG. Monochorionic twins and twin–twin transfusion syndrome: the protective role of arterio-arterial anastomoses. Placenta. 2002;23:201–209
  78. Umur A, Van Gemert MJ, Ross MG. Amniotic fluid and hemodynamic model in monochorionic twin pregnancies and twin–twin transfusion syndrome. Am J Physiol Regul Integr Comp Physiol. 2001;280:R1499–R1509
  79. Umur A, Van Gemert MJ, Ross MG. Fetal urine and amniotic fluid in monochorionic twins with twin–twin transfusion syndrome: simulations of therapy. Am J Obstet Gynecol. 2001;185:996–1003
  80. Umur A, van Gemert MJ, Ross MG. Does amniotic fluid volume affect fetofetal transfusion in monochorionic twin pregnancies? Modelling two possible mechanisms. Phys Med Biol. 2002;47:2165–2177
  81. van den Wijngaard JP, Westerhof BE, Ross MG, van Gemert MJ. A mathematical model of twin–twin transfusion syndrome with pulsatile arterial circulations. Am J Physiol Regul Integr Comp Physiol. 2007;292:R1519–R1531
  82. Zosmer N, Bajoria R, Weiner E, Rigby M, Vaughan J, Fisk N. Clinical and echographic features of in utero cardiac dysfunction in the recipient twin in twin–twin transfusion syndrome. Br Heart J. 1994;72:74–79
  83. Mahieu-Caputo D, Salomon LJ, Le Bidois J, Fermont L, Brunhes A, Jouvet P, et al. Fetal hypertension: an insight into the pathogenesis of the twin–twin transfusion syndrome. Prenat Diagn. 2003;23:640–645
  84. Lougheed J, Sinclair BG, Fung Kee Fung K, Bigras JL, Ryan G, Smallhorn JF, et al. Acquired right ventricular outflow tract obstruction in the recipient twin in twin–twin transfusion syndrome. J Am Coll Cardiol. 2001;38:1533–1538
  85. Bahtiyar MO, Dulay AT, Weeks BP, Friedman AH, Copel JA. Prevalence of congenital heart defects in monochorionic/diamniotic twin gestations: a systematic literature review. J Ultrasound Med. 2007;26:1491–1498
  86. Taylor MJ, Shalev E, Tanawattanacharoen S, Jolly M, Kumar S, Weiner E, et al. Ultrasound-guided umbilical cord occlusion using bipolar diathermy for Stage III/IV twin–twin transfusion syndrome. Prenat Diagn. 2002;22:70–76
  87. Vanderheyden TM, Fichera A, Pasquini L, Tan TY, Wee LY, Frusca T, et al. Increased latency of absent end-diastolic flow in the umbilical artery of monochorionic twin fetuses. Ultrasound Obstet Gynecol. 2005;26:44–49
  88. Bajoria R, Sullivan M, Fisk NM. Endothelin concentrations in monochorionic twins with severe twin–twin transfusion syndrome. Human Reproduction. 1999;14:1614–1618
  89. Lopriore E, Bokenkamp R, Rijlaarsdam M, Sueters M, Vandenbussche FP, Walther FJ. Congenital heart disease in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery. Congenit Heart Dis. 2007;2:38–43
  90. Kilby MD, Platt C, Whittle MJ, Oxley J, Lindop GB. Renin gene expression in fetal kidneys of pregnancies complicated by twin–twin transfusion syndrome. Pediatr Dev Pathol. 2001;4:175–179
  91. Mahieu-Caputo D, Muller F, Joly D, Gubler MC, Lebidois J, Fermont L, et al. Pathogenesis of twin–twin transfusion syndrome: the renin–angiotensin system hypothesis. Fetal Diagn Ther. 2001;16:241–244
  92. Mahieu-Caputo D, Meulemans A, Martinovic J, Gubler MC, Delezoide AL, Muller F, et al. Paradoxic activation of the renin–angiotensin system in twin–twin transfusion syndrome: an explanation for cardiovascular disturbances in the recipient. Pediatr Res. 2005;58:685–688
  93. Berry SM, Puder KS, Bottoms SF, Uckele JE, Romero R, Cotton DB. Comparison of intrauterine hematologic and biochemical values between twin pairs with and without stuck twin syndrome. Am J Obstet Gynecol. 1995;172:1403–1410
  94. Fuchs S, Philippe J, Germain S, Mathieu F, Jeunemaitre X, Corvol P, et al. Functionality of two new polymorphisms in the human renin gene enhancer region. J Hypertens. 2002;20:2391–2398
  95. Sebire NJ, Souka A, Skentou H, Geerts L, Nicolaides KH. Early prediction of severe twin-to-twin transfusion syndrome. Hum Reprod. 2000;15:2008–2010
  96. Sebire NJ, D'Ercole C, Carvelho M, Sepulveda W, Nicolaides KH. Inter-twin membrane folding in monochorionic pregnancies. Ultrasound Obstet Gynecol. 1998;11:324–327
  97. Denbow ML, Cox P, Talbert D, Fisk NM. Colour Doppler energy insonation of placental vasculature in monochorionic twins: absent arterio-arterial anastomoses in association with twin-to-twin transfusion syndrome. Br J Obstet Gynaecol. 1998;105:760–765
  98. Lewi L, Lewi P, Diemert A, Jani J, Gucciardo L, Van Mieghem T, et al. The role of ultrasound examination in the first trimester and at 16 weeks' gestation to predict fetal complications in monochorionic diamniotic twin pregnancies. Am J Obstet Gynecol. 2008;199(493):e1–e7
  99. Machin GA. Velamentous cord insertion in monochorionic twin gestation – an added risk factor. J Reprod Med. 1997;42(12):785–789
  100. Fick AL, Feldstein VA, Norton ME, Wassel Fyr C, Caughey AB, Machin GA. Unequal placental sharing and birth weight discordance in monochorionic diamniotic twins. Am J Obstet Gynecol. 2006;195:178–183
  101. Lopriore E, Sueters M, Middeldorp JM, Oepkes D, Walther FJ, Vandenbussche FP. Velamentous cord insertion and unequal placental territories in monochorionic twins with and without twin-to-twin-transfusion syndrome. Am J Obstet Gynecol. 2007;196(159):e1–e5
  102. In:  Kilby MD,  Baker P,  Critchley H,  Field D editor. Multiple pregnancy. Proceedings of the 50th RCOG study group. London: RCOG Press; 2006;
  103. Sueters M, Middeldorp JM, Oepkes D, Lopriore E, Vandenbussche FP. Twin-to-twin transfusion syndrome at 11 weeks of gestation. Am J Obstet Gynecol. 2005;193:887–888
  104. Quintero RA, Dickinson JE, Morales WJ, Bornick PW, Bermudez C, Cincotta R, et al. Stage-based treatment of twin–twin transfusion syndrome. Am J Obstet Gynecol. 2003;188:1333–1340
  105. Quintero RA, Ishii K, Chmait RH, Bornick PW, Allen MH, Kontopoulos EV. Sequential selective laser photocoagulation of communicating vessels in twin–twin transfusion syndrome. J Matern Fetal Neonatal Med. 2007;20:763–768
  106. Huber A, Diehl W, Zikulnig L, Bregenzer T, Hackeloer BJ, Hecher K. Perinatal outcome in monochorionic twin pregnancies complicated by amniotic fluid discordance without severe twin–twin transfusion syndrome. Ultrasound Obstet Gynecol. 2006;27:48–52
  107. Ville Y. Twin-to-twin transfusion syndrome: time to forget the Quintero staging system?. Ultrasound Obstet Gynecol. 2007;30:924–927
  108. Murakoshi T, Ishii K, Nakata M, Sago H, Hayashi S, Takahashi Y, et al. Validation of Quintero stage III sub-classification for twin–twin transfusion syndrome based on visibility of donor bladder: characteristic differences in pathophysiology and prognosis. Ultrasound Obstet Gynecol. 2008;32:813–818
  109. Souka AP, Heath V, Flint S, Sevastopoulou I, Nicolaides KH. Cervical length at 23 weeks in twins in predicting spontaneous preterm delivery. Obstet Gynecol. 1999;94:450–454
  110. Rouse DJ, Caritis SN, Peaceman AM, Sciscione A, Thom EA, Spong CY, et al. A trial of 17 alpha-hydroxyprogesterone caproate to prevent prematurity in twins. N Engl J Med. 2007;357:454–461
  111. Berghella V, Odibo AO, To MS, Rust OA, Althuisius SM. Cerclage for short cervix on ultrasonography: meta-analysis of trials using individual patient-level data. Obstet Gynecol. 2005;106:181–189
  112. Robyr R, Boulvain M, Lewi L, Huber A, Hecher K, Deprest J, et al. Cervical length as a prognostic factor for preterm delivery in twin-to-twin transfusion syndrome treated by fetoscopic laser coagulation of chorionic plate anastomoses. Ultrasound Obstet Gynecol. 2005;25:37–41
  113. Engineer N, O'Donoghue K, Wimalasundera RC, Fisk NM. The effect of polyhydramnios on cervical length in twins: a controlled intervention study in complicated monochorionic pregnancies. PLoS one. 2008;3:e3834
  114. Salomon LJ, Nasr B, Nizard J, Bernard JP, Essaoui M, Bussieres L, et al. Emergency cerclage in cases of twin-to-twin transfusion syndrome with a short cervix at the time of surgery and relationship to perinatal outcome. Prenat Diagn. 2008;28:1256–1261
  115. Herberg U, Gross W, Bartmann P, Banek CS, Hecher K, Breuer J. Long term cardiac follow up of severe twin to twin transfusion syndrome after intrauterine laser coagulation. Heart. 2006;92:95–100
  116. Van Mieghem T, Gucciardo L, Lewi P, Lewi L, Van Schoubroeck D, Devlieger R, et al. Validation of the fetal myocardial performance index in the second and third trimesters of gestation. Ultrasound Obstet Gynecol. 2008;33:58–63
  117. Rychik J, Tian Z, Bebbington M, Xu F, McCann M, Mann S, et al. The twin–twin transfusion syndrome: spectrum of cardiovascular abnormality and development of a cardiovascular score to assess severity of disease. Am J Obstet Gynecol. 2007;197(392):e1–e8
  118. Raboisson MJ, Fouron JC, Lamoureux J, Leduc L, Grignon A, Proulx F, et al. Early intertwin differences in myocardial performance during the twin-to-twin transfusion syndrome. Circulation. 2004;110:3043–3048
  119. Bensouda B, Fouron JC, Raboisson MJ, Lamoureux J, Lachance C, Leduc L. Relevance of measuring diastolic time intervals in the ductus venosus during the early stages of twin–twin transfusion syndrome. Ultrasound Obstet Gynecol. 2007;30:983–987
  120. Shah AD, Border WL, Crombleholme TM, Michelfelder EC. Initial fetal cardiovascular profile score predicts recipient twin outcome in twin–twin transfusion syndrome. J Am Soc Echocardiogr. 2008;21:1105–1108
  121. Froster UG, Jackson L. Limb defects and chorionic villus sampling: results from an international registry, 1992–94. Lancet. 1996;347:489–494
  122. Lopriore E, Lewi L, Oepkes D, Debeer A, Vandenbussche FP, Deprest J, et al. In utero acquired limb ischemia in monochorionic twins with and without twin-to-twin transfusion syndrome. Prenat Diagn. 2008;28:800–804
  123. Carr SR, Luks F, Tracy T, Plevyak M. Antenatal necrotic injury in severe twin-to-twin transfusion syndrome. A case and review. Fetal Diagn Ther. 2004;19:370–372
  124. Hecher K, Ville Y, Nicolaides K. Umbilical artery steal syndrome and distal gangrene in a case of twin–twin transfusion syndrome. Obstet Gynecol. 1994;83:862–865
  125. Dawkins RR, Marshall TL, Rogers MS. Prenatal gangrene in association with twin–twin transfusion syndrome. Am J Obstet Gynecol. 1995;172:1055–1057
  126. Scott F, Evans N. Distal gangrene in a polycythemic recipient fetus in twin–twin transfusion. Obstet Gynecol. 1995;86:677–679
  127. Margono F, Feinkind L, Minkoff HL. Foot necrosis in a surviving fetus associated with twin–twin transfusion syndrome and monochorionic placenta. Obstet Gynecol. 1992;79:867–869
  128. Cincotta R, Oldham J, Sampson A. Antepartum and postpartum complications of twin–twin transfusion. Aust N Z J Obstet Gynaecol. 1996;36:303–308
  129. Simonazzi G, Segata M, Ghi T, Sandri F, Ancora G, Bernardi B, et al. Accurate neurosonographic prediction of brain injury in the surviving fetus after the death of a monochorionic cotwin. Ultrasound Obstet Gynecol. 2006;27:517–521
  130. Jelin AC, Norton ME, Bartha AI, Fick AL, Glenn OA. Intracranial magnetic resonance imaging findings in the surviving fetus after spontaneous monochorionic cotwin demise. Am J Obstet Gynecol. 2008;199(398):e1–e5
  131. Kline-Fath BM, Calvo-Garcia MA, O'Hara SM, Crombleholme TM, Racadio JM. Twin–twin transfusion syndrome: cerebral ischemia is not the only fetal MR imaging finding. Pediatr Radiol. 2007;37:47–56
  132. Ong SS, Zamora J, Khan KS, Kilby MD. Prognosis for the co-twin following single-twin death: a systematic review. BJOG. 2006;113:992–998
  133. Righini A, Kustermann A, Parazzini C, Fogliani R, Ceriani F, Triulzi F. Diffusion-weighted magnetic resonance imaging of acute hypoxic–ischemic cerebral lesions in the survivor of a monochorionic twin pregnancy: case report. Ultrasound Obstet Gynecol. 2007;29:453–456
  134. O'Donoghue K, Rutherford MA, Engineer N, Wimalasundera RC, Cowan FM, Fisk NM. Transfusional fetal complications after single intrauterine death in monochorionic multiple pregnancy are reduced but not prevented by vascular occlusion. BJOG, in press.
  135. Cavicchioni O, Yamamoto M, Robyr R, Takahashi Y, Ville Y. Intrauterine fetal demise following laser treatment in twin-to-twin transfusion syndrome. BJOG. 2006;113:590–594
  136. Lopriore E, van Wezel-Meijler G, Middeldorp JM, Sueters M, Vandenbussche FP, Walther FJ. Incidence, origin, and character of cerebral injury in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery. Am J Obstet Gynecol. 2006;194:1215–1220
  137. Denbow ML, Battin MR, Cowan F, Azzopardi D, Edwards AD, Fisk NM. Neonatal cranial ultrasonographic findings in preterm twins complicated by severe fetofetal transfusion syndrome. Am J Obstet Gynecol. Mar 1998;178:479–483
  138. Quarello E, Molho M, Ville Y. Incidence, mechanisms, and patterns of fetal cerebral lesions in twin-to-twin transfusion syndrome. J Matern Fetal Neonatal Med. 2007;20:589–597
  139. Yamamoto M, El Murr L, Robyr R, Leleu F, Takahashi Y, Ville Y. Incidence and impact of perioperative complications in 175 fetoscopy-guided laser coagulations of chorionic plate anastomoses in fetofetal transfusion syndrome before 26 weeks of gestation. Am J Obstet Gynecol. 2005;193:1110–1116
  140. Lee YM, Wylie BJ, Simpson LL, D'Alton ME. Twin chorionicity and the risk of stillbirth. Obstet Gynecol. 2008;111:301–308
  141. Simoes T, Amaral N, Lerman R, Ribeiro F, Dias E, Blickstein I. Prospective risk of intrauterine death of monochorionic–diamniotic twins. Am J Obstet Gynecol. 2006;195:134–139
  142. Klaritsch P, Albert K, Van Mieghem T, Gucciardo L, Done E, Bynens B, et al. Instrumental requirements for minimal invasive fetal surgery. BJOG. 2009;116:188–197
  143. Quintero RA, Bornick PW, Allen MH, Johson PK. Selective laser photocoagulation of communicating vessels in severe twin–twin transfusion syndrome in women with an anterior placenta. Obstet Gynecol. 2001;97:477–481
  144. Huber A, Baschat AA, Bregenzer T, Diemert A, Tchirikov M, Hackeloer BJ, et al. Laser coagulation of placental anastomoses with a 30 degrees fetoscope in severe mid-trimester twin–twin transfusion syndrome with anterior placenta. Ultrasound Obstet Gynecol. 2008;31:412–416
  145. Deprest JA, VanSchoubroeck D, VanBallaer PP, Flageole H, VanAssche FA, Vandenberghe K. Alternative technique for Nd:YAG laser coagulation in twin-to-twin transfusion syndrome with anterior placenta. Ultrasound Obstet Gynecol. 1998;11:347–352
  146. 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;332:224–227
  147. Quintero RA, Comas C, Bornick PW, Allen MH, Kruger M. Selective versus non-selective laser photocoagulation of placental vessels in twin-to-twin transfusion syndrome. Ultrasound Obstet Gynecol. 2000;16:230–236
  148. Feldstein VA, Machin GA, Albanese CT, Sandberg P, Farrell JA, Farmer DL, et al. Twin–twin transfusion syndrome: the ‘Select’ procedure. Fetal Diagn Ther. 2000;15:257–261
  149. Bajoria R, Wee LY, Anwar S, Ward S. Outcome of twin pregnancies complicated by single intrauterine death in relation to vascular anatomy of the monochorionic placenta. Hum Reprod. 1999;14:2124–2130
  150. Stirnemann JJ, Nasr B, Quarello E, Ortqvist L, Nassar M, Bernard JP, et al. A definition of selectivity in laser coagulation of chorionic plate anastomoses in twin-to-twin transfusion syndrome and its relationship to perinatal outcome. Am J Obstet Gynecol. 2008;198(62):e1–e6
  151. van Gemert MJ, van den Wijngaard JP, Lopriore E, Lewi L, Deprest J, Vandenbussche FP. Simulated sequential laser therapy of twin–twin transfusion syndrome. Placenta. 2008;29:609–613
  152. Fisk NM, Galea P. Twin–twin transfusion – as good as it gets?. N Engl J Med. 2004;351:182–184
  153. Rossi AC, D'Addario V. Laser therapy and serial amnioreduction as treatment for twin–twin transfusion syndrome: a metaanalysis and review of literature. Am J Obstet Gynecol. 2008;198:147–152
  154. Rossi AC, D'Addario V. Comparison of donor and recipient outcomes following laser therapy performed for twin–twin transfusion syndrome: a meta-analysis and review of literature. Am J Perinatol. 2009;26:27–32
  155. Dickinson JE, Duncombe GJ, Evans SF, French NP, Hagan R. The long term neurologic outcome of children from pregnancies complicated by twin-to-twin transfusion syndrome. BJOG. 2005;112:63–68
  156. Lopriore E, Middeldorp JM, Sueters M, Oepkes D, Vandenbussche FP, Walther FJ. Long-term neurodevelopmental outcome in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery. Am J Obstet Gynecol. 2007;196(231):e1–e4
  157. Örtqvist L, Bussieres L, Staraci S, Fermanian C, Ville Y. Long-term neurodevelopmental outcome in twin-to-twin transfusion syndrome (Ttts) in the eurofoetus trial. Am J Obstet Gynecol. 2008;199:S118
  158. Middeldorp JM, Lopriore E, Sueters M, Klumper FJ, Kanhai HH, Vandenbussche FP, et al. Twin-to-twin transfusion syndrome after 26 weeks of gestation: is there a role for fetoscopic laser surgery?. BJOG. 2007;114:694–698
  159. Hecher K, Diehl W, Zikulnig L, Vetter M, Hackeloer BJ. Endoscopic laser coagulation of placental anastomoses in 200 pregnancies with severe mid-trimester twin-to-twin transfusion syndrome. Eur J Obstet Gynecol Reprod Biol. 2000;92:135–139
  160. Martinez JM, Bermudez C, Becerra C, Lopez J, Morales WJ, Quintero RA. The role of Doppler studies in predicting individual intrauterine fetal demise after laser therapy for twin–twin transfusion syndrome. Ultrasound Obstet Gynecol. 2003;22:246–251
  161. Habli M, Livingston J, Harmon J, Lim FY, Plozin W, Crombleholme T. The outcome of twin–twin transfusion syndrome complicated with placental insufficiency. Am J Obstet Gynecol. 2008;199(424):e1–e6
  162. Chmait RH, Korst LM, Bornick PW, Allen MH, Quintero RA. Fetal growth after laser therapy for twin–twin transfusion syndrome. Am J Obstet Gynecol. 2008;199(47):e1–e6
  163. 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;28:204–208
  164. O'Donoghue K, Barigye O, Pasquini L, Chappell L, Wimalasundera RC, Fisk NM. Interstitial laser therapy for fetal reduction in monochorionic multiple pregnancy: loss rate and association with aplasia cutis congenita. Prenat Diagn. 2008;28:535–543
  165. Moise KJ, Johnson A, Moise KY, Nickeleit V. Radiofrequency ablation for selective reduction in the complicated monochorionic gestation. Am J Obstet Gynecol. 2008;198(198):e1–e5
  166. Moise KJ, Dorman K, Lamvu G, Saade GR, Fisk NM, Dickinson JE, et al. A randomized trial of amnioreduction versus septostomy in the treatment of twin–twin transfusion syndrome. Am J Obstet Gynecol. 2005;193:701–707
  167. Wilson RD, Johnson A, Ryan G. Current controversies in prenatal diagnosis 2: should laser ablation of placental anastomoses be used in all cases of twin to twin transfusion?. Prenat Diagn. 2008;
  168. Fisk NM, Tan TY, Taylor MJ. Re: Stage-based treatment of twin–twin transfusion syndrome. Am J Obstet Gynecol. 2004;190:1809–1810
  169. Moise KJ. Neurodevelopmental outcome after laser therapy for twin–twin transfusion syndrome. Am J Obstet Gynecol. 2006;194:1208–1210
  170. Dickinson JE, Evans SF. The progression of disease stage in twin–twin transfusion syndrome. J Matern Fetal Neonatal Med. 2004;16:95–101
  171. Bebbington M, Tiblad E, Wilson R, Mann S, Huesler-Charles M, Johnson M. Outcomes in a cohort of patients with stage 1 twin–twin transfusion syndrome. Ultrasound Obstet Gynecol. 2007;30:Abstract OP10.04
  172. Quintero RA, Kontopoulos EV, Chmait R, Bornick PW, Allen M. Management of twin–twin transfusion syndrome in pregnancies with iatrogenic detachment of membranes following therapeutic amniocentesis and the role of interim amniopatch. Ultrasound Obstet Gynecol. 2005;26:628–633
  173. Middeldorp JM, Sueters M, Lopriore E, Klumper FJ, Oepkes D, Devlieger R, et al. Fetoscopic laser surgery in 100 pregnancies with severe twin-to-twin transfusion syndrome in the Netherlands. Fetal Diagn Ther. 2007;22:190–194

PII: S0143-4004(09)00064-2

doi: 10.1016/j.placenta.2009.02.005

Placenta
Volume 30, Issue 5 , Pages 379-390 , May 2009

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