Single fetal death in twin gestations

Blickstein, Isaac; Perlman, Sharon

doi:10.1515/jpm-2012-0019

Cited by 103 publications

(31 citation statements)

References 30 publications

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“…While intrauterine exitus of one baby does not cause any problems for the other baby in first trimester, this may cause serious complications for the mother and other baby in the second and third trimesters. The primary complications can be disseminated intravascular coagulopathy, anaemia, sepsis, nephrological problems, neurological damages, and premature birth (8,9). Our patient was a term baby and the other sibling had died in the 3rd trimester; the findings detected on physical examination were primarily evaluated as sepsis and disseminated intravascular coagulopathy triggered by sepsis.…”

mentioning

confidence: 92%

“…This may cause serious complications for both the mother and the other living baby. The living baby may suffer from complications such as preterm birth, central nervous system defects, early onset-late onset sepsis, renal anomalies, disseminated intravascular coagulopathy (DIC), and skin defects (8,9). In this report, we are presenting the case of a surviving twin who developed DIC while the other had intauterin exitus and how underlying inherited hemorrhagic diathesis may be concealed causing diagnostic delay.…”

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confidence: 99%

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Glanzmann Thrombasthenia Mimicking Early Neonatal Sepsis

Demir¹,

Kaba²,

Garipardıç³

et al. 2015

J Turgut Ozal Med Cent

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Glanzmann thrombasthenia is an autosomal and recessively inherited disorder resulting from abnormality in the first step of thrombosis. In cases associated with hemorrhagic diathesis and ecchymotic mucocutaneous lesions, Glanzmann thrombasthenia should be taken into account in differential diagnosis if thrombocyte count is normal and bleeding duration is too long. In this study, we present the case of a pair of twins in which one of the siblings was lost in the uterus while the other had sepsis along with common intravascular coagulopathy and was eventually diagnosed with Glanzmann thrombasthenia. Key Word: Glanzmann; Sepsis; Hemorrhagic Diathesis. Erken Neonatal Sepsisi Andıran bir Glanzman Trombasteni OlgusuÖzet Glanzmann trombastenisi pıhtı oluşumunun ilk basamağındaki anormalikten kaynaklanan otozomal resesif geçişli kalıtsal bir hastalıktır. Ekimotik mukokütenöz leziyonlarla ve kana diateziyle ilişkili olgularda, eğer trombosit sayısı normal, kanama zamanı uzun ise Glanzamann trombastenisi ayırıcı tanıda düşünülmelidir. Burada ikiz eşi olarak doğan, diğer ikizi intauterin exitus olan ve yaygın intravasküler koagulopati ve sepsis tablosuyla gelen ardından GT tanısı konan bir olgu sunuldu.

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confidence: 92%

mentioning

confidence: 99%

Glanzmann Thrombasthenia Mimicking Early Neonatal Sepsis

Demir¹,

Kaba²,

Garipardıç³

et al. 2015

J Turgut Ozal Med Cent

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“…This necessitates the protective effect of vascular occlusion to preserve neurological integrity. (16)(17)(18)(19)(20) Although bipolar laser cord coagulation achieves this end, specialist equipment and fetoscopy skills are required. RFA, in Rapid initiation of fetal therapy services with a system of Rapid initiation of fetal therapy services with a system of learner-centred training under proctorship: the National learner-centred training under proctorship: the National University Hospital (Singapore) experience University Hospital (Singapore) experience contrast, is easier to adopt, requiring a straightforward application of sonographic and fetal blood sampling skills.…”

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confidence: 99%

Rapid initiation of fetal therapy services with a system of learner-centred training under proctorship: the National University Hospital (Singapore) experience

Gosavi

Vijayakumar

et al. 2017

smedj

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INTRODUCTION Management of complicated monochorionic twins and certain intrauterine structural anomalies is a pressing challenge in communities that still lack advanced fetal therapy. We describe our efforts to rapidly initiate selective feticide using radiofrequency ablation (RFA) and selective fetoscopic laser photocoagulation (SFLP) for twin-to-twin transfusion syndrome (TTTS), and present the latter as a potential model for aspiring fetal therapy units. METHODSFive pregnancies with fetal complications were identifi ed for RFA. Three pregnancies with Stage II TTTS were selected for SFLP. While RFA techniques utilising ultrasonography skills were quickly mastered, SFLP required stepwise technical learning with an overseas-based proctor, who provided real-time hands-off supervision.RESULTS All co-twins were live-born following selective feticide; one singleton pregnancy was lost. Fetoscopy techniques were learned in a stepwise manner and procedures were performed by a novice team of surgeons under proctorship. Dichorionisation was completed in only one patient. Five of six twins were live-born near term. One pregnancy developed twin anaemia-polycythaemia sequence, while another was complicated by co-twin demise.DISCUSSION Proctor-supervised directed learning facilitated the rapid provision of basic fetal therapy services by our unit. While traditional apprenticeship is important for building individual expertise, this system is complementary and may benefi t other small units committed to providing these services.

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“…Окклюзия сосудов пуповины обеспечивает полное прекращение кровотока в ней и предотвращает острую кровопотерю у живого плода при гибели одного близнеца из монохориальной двойни, что приводит к его смерти или грубым неврологическим нарушениям [8,9]. Проце-дура может выполняться с использованием различных ме-тодик: инъекции 96° этанола во внутрибрюшную часть артерии пуповины, перевязки пуповины при фетоскопии, биполярной коагуляции сосудов пуповины, радиочастот-ной аблации сосудов пуповины, введения в артерии пупо-вины под эхографическим контролем тромбогенной спи-рали, введения эмболов в кровеносную систему акарди-ального плода, гистеротомии и селективного родоразре-шения акардиального плода [10][11][12][13][14].…”

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