Three‐dimensional power Doppler in the diagnosis and surgical management of thoraco‐omphalopagus conjoined twins

Wataganara, Tuangsit; Sutanthaviboon, A.; Ngerncham, Sopapan; Vantanasiri, Chanchai

doi:10.1002/uog.5326

Cited by 11 publications

(9 citation statements)

References 3 publications

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“…Conjoined twin cases are rare with a female predominance and omphalopagus twins are frequently joined at the level of the umbilicus [ 1 , 2 ]. Although conjoined twins are preferred to be delivered in the 36th–38th weeks by caesarean section, many are premature, as in our case.…”

Section: Discussionmentioning

confidence: 99%

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Decreased Brain and Placental Perfusion in Omphalopagus Conjoined Twins on Fetal MRI

Görkem

Kütük

Doğanay

et al. 2016

Radiology Research and Practice

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The aim of this study is to evaluate perfusional changes in brain and placenta of omphalopagus conjoined twins and to compare them with singleton fetuses by using diffusion weighted imaging and apparent diffusion coefficient. Fetal MRIs of 28-week-old omphalopagus conjoined twins with a shared liver with two separate gallbladders and portal and hepatic venous systems and three singleton fetuses with unilateral borderline ventriculomegaly at the same gestational week as control group were enrolled retrospectively. There was a significant decrease in ADC values of brain regions (p = 0.018) and placenta (p = 0.005) of conjoined twins compared to the control group. The decreased ADC values in placenta and brain regions in conjoined twins might be due to decreased placental perfusion compared to singleton pregnancy. Our results would be a keystone for future studies which will compare larger group of monochorionic multiple pregnancies with singleton pregnancies.

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Section: Discussionmentioning

confidence: 99%

“…Those twins are monozygotic, monoamniotic, and monochorionic. Multiple anomalies including cardiac and circulatory anomalies, congenital diaphragm hernia, intestinal atresia, neural tube defects, or cystic hygroma can be associated [ 2 , 3 ]. Omphalopagus twins account for 18–33% in which liver fuses in 80% of cases.…”

Section: Introductionmentioning

confidence: 99%

Decreased Brain and Placental Perfusion in Omphalopagus Conjoined Twins on Fetal MRI

Görkem

Kütük

Doğanay

et al. 2016

Radiology Research and Practice

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“…Cases with false-positive diagnoses in the first trimester have been documented; therefore, an exact diagnosis should be made with caution (19). This technique may also provide images that are easier for parents to understand, which can help in decision making (20,21). Parasitic twins are a rare form of conjoined twins and consist of an incomplete twin (parasite) attached to the fully developed body of the co-twin (autosite).…”

Section: Discussionmentioning

confidence: 99%

Prenatal diagnosis of conjoined twins: Four cases in a prenatal center

Gedikbaşı¹,

Yıldırım²,

Saygılı³

et al. 2010

J Turkish German Gynecol Assoc

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reviewed the database and medical records of 857 twin pregnancies, including 140 monochorionic twins. Nineteen monochorionic-monoamniotic twin pregnancies were detected, four of which were complicated by conjoined twins.Results: Of these 4 cases, 2 were complicated by thoracopagus and one had thoraco-omphalopagus; these three cases underwent termination at 16, 11, and 19 weeks gestation, respectively. The last case was diagnosed as a pygopagus tetrapus parasitic twin at 28 weeks gestation. The family decided to continue the pregnancy, and achieved a successful outcome with elective surgery postpartum. Conclusion:Conjoined twins are an uncommon and complex complication of monozygotic gestations, which is associated with high perinatal mortality. The early prenatal diagnosis of conjoined twins allows improved counseling about the management options, including maintenance of pregnancy with surgery after delivery or termination of pregnancy. (J Turkish-German Gynecol Assoc 2010; 11: 174-7) Key words: Conjoined twins, prenatal diagnosis Received: 22 December, 2009 Accepted: 11 February, 2010 Amaç: Prenatal olarak tanısı konmuş yapışık ikiz olgularında bulguların değerlendirilmesi. Gereç ve Abstract ÖzetOriginal Investigation 174

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“…1 and 2 . Three-dimensional sonoangiography has been reportedly used to assess the complex circulation shared between conjoined twins [ 2 , 3 ]. Another rare and severe complication of monochorionicity is the twins reversed arterial perfusion (TRAP) sequence, which occurs when the heart of a normal-appearing twin serves as the pump for an acardiac twin.…”

Section: Advances In Prenatal Ultrasound For Diagnosis and Prognosticmentioning

confidence: 99%

Advanced ultrasound for prenatal interventions

et al. 2018

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Ultrasound is an integral part of prenatal interventions. Doppler studies and 3-dimensional ultrasound (3DUS) are frequently used to determine whether fetal surgery is required. The operator’s experience remains crucial for reducing procedure-related morbidity. Real-time 3DUS (or 4DUS) can simultaneously display the needle tip in three orthogonal planes, providing reassurance that no fetal parts are in the path. In experienced hands, 4DUS guidance may not be more effective than B-mode, but its value for less-experienced operators remains to be determined. Recent developments in needle, shunt, and video endoscopic technologies may compliment the use of image-guided in utero procedures. Future developments of higher-dimensional transducers and image software may improve the utility of ultrasound for invasive obstetric interventions.

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Three‐dimensional power Doppler in the diagnosis and surgical management of thoraco‐omphalopagus conjoined twins

Cited by 11 publications

References 3 publications

Decreased Brain and Placental Perfusion in Omphalopagus Conjoined Twins on Fetal MRI

Decreased Brain and Placental Perfusion in Omphalopagus Conjoined Twins on Fetal MRI

Prenatal diagnosis of conjoined twins: Four cases in a prenatal center

Advanced ultrasound for prenatal interventions

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