Second trimester amniocentesis in twin pregnancies: maternal haemoglobin as a dye marker to differentiate diamniotic twins

Abstract

Objective To review the use of a membrane‐free haemolysate prepared from maternal blood to distinguish the amniotic sacs at amniocentesis in twin gestation. Setting University Hospital, Groningen. Method Haemoglobin solution prepared from maternal blood. Subjects 63 twin pregnancies having amniocentesis. Results The fetal loss before 28 weeks was 4%. There was no perinatal mortality. Dye was detected in the second sac in 9 of 24 women tested before 1985 and none of the 39 women since, no malformations could be ascribed to the use of the haemolysate. Conclusion The use of the membrane‐free haemolysate is safe, but the technique will probably gradually become redundant because of improved ultrasound.

Fetal Death After Exposure to Methylene Blue Dye During Mid-Trimester Amniocentesis in Twin Pregnancy

“…This figure may be an underestimate since without close monitoring of fetuses from the stage of identification of a twin pregnancy or by examination of the placenta, some affected fetuses are likely to remain undetected, compressed against the placenta at delivery. On the one hand, a fetus papyraceous does not pose major problems during gestation or delivery, with the diagnosis made after delivery of the surviving fetus (Bryan, 1992;Saier et al, 1975). On the other hand, case reports of intestinal atresia and congenital skin defects in the surviving twins thought to be due to transfer of emboli have been described (Saier et al, 1975;Wagner et al, 1990).…”

“…On the one hand, a fetus papyraceous does not pose major problems during gestation or delivery, with the diagnosis made after delivery of the surviving fetus (Bryan, 1992;Saier et al, 1975). On the other hand, case reports of intestinal atresia and congenital skin defects in the surviving twins thought to be due to transfer of emboli have been described (Saier et al, 1975;Wagner et al, 1990). None of the surviving twins in our series of fetus papyraceous had intestinal atresia, although skin defects may be unreported as they are minor abnormalities.…”

Jejunal atresia related to the use of toluidine blue in genetic amniocentesis in twins

“…In experimental studies in fetal dogs atresia occurred after intrauterine ligation of mesenteric vessels [9]. In the rare cases of misposition of the fetus a membranefree hemolysate of maternal blood as a dye marker to differentiate diamniotic twins was proposed as an alternative [2]. Toluidine blue is a thiazine dye chemically related to methylene blue and may have also vasoconstrictive effects.…”

Genetic Amniocentesis in Multiple Pregnancy

“…No maternal or fetal complications were noted in conjunction with these dyes. The literature, however, reported harmful fetal complications [16,[19][20][21]. Considering the data in the literature, we decided to switch to indigo carmine in 1996.…”