Successful ablation of acardiac twin with Histoacryl

Ferianec, V.; Redecha, M; Papcun, P.; Križko, M; Hollý, I; Holomán, K

doi:10.1016/j.tjog.2014.04.033

Cited by 6 publications

(11 citation statements)

References 9 publications

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“…Other types of intrauterine therapies, such as intraumbilical application of the ablation medium in cardiac twin, remain very rare. In the case of fetal impasse it is the only way to save the fetus (18,19,20).…”

Section: Discussionmentioning

confidence: 99%

The value of cordocentesis in current management of intrauterine patient

Kunochova¹,

Papcun²,

Križko³

et al. 2019

BLL

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OBJECTIVES: Analyzing the clinical group to evaluate current indications for cordocenteses, their complications and data obtained in further pregnancy management. METHODS: Retrospective analysis evaluated 92 cordocenteses (diagnostic and therapeutic) performed during the period of 2007-2018. These were performed between 17 and 36 weeks of gestation under ultrasound guidance by a specialist at 2nd Department of Gynecology and Obstetrics, Faculty of Medicine, Comenius University. RESULTS: Out of 92 procedures, 78 were diagnostic and 14 were therapeutic. The diagnostic cordocentesis was successful in 97.4 % and intrauterine therapy was successful in 85.7 %. There were 2 (2.56 %) diagnostic cordocenteses complicated by fetal demise and 2 (14 %) intrauterine demises in therapeutic cordocentesis. The pathological karyotype was detected in 14.5 %. Aneuploidia was present in 4 cases (44.4 %), mosaicism in 4 cases (44.4 %) and triploidia in one case (11.1 %). CONCLUSION: Despite of novel molecular genetic technique cordocentesis still plays unreplaceable role in current prenatal diagnosis and treatment. The risk of complications of cordocentesis increases depending on the severity of fetal pathology in pathologic pregnancies. In some situations it can be used as a useful tool for original fetal diagnosis and therapy (Tab. 3, Ref. 20). Text in PDF www.elis.sk.

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Section: Discussionmentioning

confidence: 99%

The value of cordocentesis in current management of intrauterine patient

Kunochova¹,

Papcun²,

Križko³

et al. 2019

BLL

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“…TRAP sequence is the extreme form of TTTS, with the underlying pathophysiological mechanisms still incompletely understood. In a case with TRAP sequence, there is a normal twin which becomes the pump, its heart supporting not only its own blood flow, but also the acardiac twins' one [3]. The pump twin will eventually develop arterial-steal phenomenon, characterized by progressive cardiac insufficiency, polyhydramnios and consequently heart failure [4].…”

Section: Discussionmentioning

confidence: 99%

Monochorionic-diamniotic twin pregnancy complicated by twin reversed arterial perfusion sequence and retroplacental hematoma – a case report

et al. 2018

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Twin reversed arterial perfusion (TRAP) sequence is a rare and severe complication specific to monochorionic twin pregnancies, involving the presence of an acardiac twin and a structurally normal co-twin (pump twin). We report on the case of a33-year-old female with a biamniotic monochorionic twin pregnancy complicated with TRAP sequence and polyhydramnios. The patient underwent fetoscopic termination of the acardiac twin and at 34 gestational weeks (GW) was readmitted with aretroplacental hematoma. The patient gave birth through caesarean section to a living female fetus, weighing 1480 g. To the best of our knowledge, this is the first case reporting a twin pregnancy with TRAP sequence complicated with retroplacental hematoma.

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“…2 This last type was observed in the case that we report and it is observed in the most cases in literature. 3 TRAP syndrome could have heavy circulation consequences in the healthy fetus. This can go up to the development of cardiac insufficiency, polyhydramnios, and consequently heart failure.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, the possibility of treatment is pregnancy termination, expectation management, intrafetal ablation, or interventional anastomosis sclerotization using alcohol ablation, thermal ablation, laser ablation, bipolar coagulation or histoacryl to occlude the circulation of the acardiac twin and interrupt the TRAP sequence. 1,3,8 None of these techniques is available in Madagascar. If TRAP syndrome was diagnosed early in the case that we report, expectant management and regular ultrasound examination and cardiotocographic monitoring would have been performed to allow fetal extraction by cesarean section as soon as signs of heart failure are seen in the normal fetus at a term of fetal viability.…”

Section: Discussionmentioning

confidence: 99%

Twin Reversed Arterial Perfusion (TRAP) Syndrome or acardiac twin: a case report in Madagascar

et al. 2018

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TRAP syndrome is a rare complication of monochorionic twin pregnancy. It is characterized by the association of an acardiac twin with a healthy twin. The acardiac twin is a parasite who put the healthy twin at high risk of cardiac failure. We report a case in a 25-year-old Malagasy woman, primigravida, who had a consultation at gestational week 31 for significant dyspnea and a threat of premature delivery. Ultrasound scans discovered an acute polyhydramnios, fetus with anasarca and low cardiac activity, and a para-fetal mass. She gives birth to a male newborn and an acardiac twin without head an upper body. The first twin died short time after birth.

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Successful ablation of acardiac twin with Histoacryl

Abstract: Histoacryl is suitable for the ablation of an acardiac twin. Further studies are needed to prove the efficacy of this technique.

Cited by 6 publications

References 9 publications

The value of cordocentesis in current management of intrauterine patient

The value of cordocentesis in current management of intrauterine patient

Monochorionic-diamniotic twin pregnancy complicated by twin reversed arterial perfusion sequence and retroplacental hematoma – a case report

Twin Reversed Arterial Perfusion (TRAP) Syndrome or acardiac twin: a case report in Madagascar

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