Intrauterine surgery: how far we have come in 30 years

Hecher, Kurt

doi:10.1002/uog.23550

Cited by 1 publication

(1 citation statement)

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“…Multiple factors are responsible for this phenomenon, such as dysregulation in the renin-angiotensin system and changes in endothelin production [4]. When TTTS is left untreated, mortality rates are as high as 80-90% [5]. Fetoscopic laser surgery of placental vascular anastomoses is a minimally invasive surgical procedure and the most effective first-line therapy for TTTS [6].…”

Section: Introductionmentioning

confidence: 99%

The Current Knowledge of Cerebral Magnetic Resonance Imaging in Monochorionic Twins: A Systematic Review of the Last 20 Years

Rondagh,

Lopriore,

de Vries

et al. 2023

JCM

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The distinct placental angioarchitecture in monochorionic (MC) pregnancies increases the risk of complications such as twin–twin transfusion syndrome (TTTS), twin anemia polycythemia sequence (TAPS), and selective fetal growth restriction (sFGR). The aim of this systematic review was to evaluate the incidence, type, and severity of cerebral injury and structural brain development on fetal and/or neonatal cerebral magnetic resonance imaging (MRI) in MC twins with or without complications. Twenty-three studies were included, covering a wide range of complications observed during MC pregnancies, with studies involving sIUFD (n = 12), TTTS (n = 7), mixed complications (n = 2), TAPS (n = 1), and uncomplicated MC pregnancy (n = 1). TAPS and sFGR were largely underrepresented in the current literature. The included studies reported that MC pregnancies with single intrauterine fetal demise (sIUFD) are most at risk for cerebral injury during the fetal period. The overall median incidence of cerebral injury after sIUFD was 28.3% (0–55%). Severe antenatal cerebral injury after sIUFD was detected antenatally in 6.5% (0–36%) of the cases. Three of the included studies described the incidence, type, and severity of cerebral injury on neonatal MRI in MC twins. Structural brain development based on cerebral biometry was only assessed in two studies, revealing significantly smaller biometric measurements of the cerebrum in cases of single sIUFD or smaller twins compared to singleton pregnancies. To enhance our understanding of the potential risks and pathophysiological mechanisms associated with cerebral injury and structural brain development in MC twins, there is a need for future studies and standardized protocols using serial fetal and neonatal MRI imaging in addition to routine ultrasound imaging.

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Section: Introductionmentioning

confidence: 99%