Ultrasound has revolutioned the care of women carring twins. First trimester evaluation is the best time to determine chorioniocity and amnioniocity in multiple gestations. First trimester diagnosis is based on the number of gestational sacs, amnions and yolk sacs. Growth rate in multiple multiple gestations during the fist and early second trimesters parallels the growth rate of singleton preg...

We report neurologic damage in twins that was associated with twin-twin transfusion syndrome. Intracranial hemorrhage, detected prenatally, was seen in the larger twin , and periventricular leukomalacia was identified on the first day of life in the smaller twin . Recognition of fetal intracerebral hemorrhage on prenatal sonograms is uncommon; it has been reported only three times (1-3] . The p...

Twin-to-twin transfusion syndrome is a severe complication occurring in 10% of monochorionic twin pregnancies. The disease is usually explained as due to an intrauterine imbalance in intertwin blood exchange, which leads to a volume depleted-donor twin and an overfilled recipient twin. The recipient has signs of cardiac dysfunction, which can be measured using echocardiography or blood and amni...

The incidence of multiple pregnancy has increased by 1.7 times from 1980-1994. Twenty-five percent of all twins are monochorionic diamnionic. The perinatal mortality of monochorionic twins is five times greater than that found in dichorionic twins and the morbidity is eight times greater. The increase in morbidity is due to prematurity, cerebral lesions and congenital malformations. One of the ...

Twin to twin transfusion syndrome (TTTS) is a specific condition complicating 10-15% of monochorionic multiple pregnancy. Intertwin vascular anastomoses and transfusion is a normal event. Syndrome develops when blood flow is unbalanced. Recent studies suggest a paucity of bi-directional superficial anastomoses failing to compensate for hemodynamic imbalance resulting from unidirectional transfu...

Twin-to-Twin Transfusion Syndrome (TTTS) is a rare placental disease that can occur at any time during pregnancy [5] involving identical twins. TTTS occurs when there is an unequal distribution of placental blood vessels between fetuses, which leads to a disproportionate supply of blood delivered. This unequal allocation of blood leads to developmental problems in both fetuses that can range in...

PURPOSE OF REVIEW Despite the recent demonstration of the benefit of the primary laser over amnioreduction, overall survival is far from optimal (70-80%), and therefore diagnosis and management of early and late complications following placental surgery became of great importance. RECENT FINDINGS Laser therapy has proven to be better than amnioreduction in treating twin-to-twin transfusion sy...

Objective: To test the hypothesis that identical twins show no inter-twin differences in cardiovascular structure or physiology in fetal life unless there has been twin-twin transfusion syndrome. Design: Unselected prospective case–control observational study of fetoplacental haemodynamics including echocardiography at a median of 24 (16.7 to 32.3) weeks, with postnatal confirmation of congenit...

OBJECTIVE To test the hypothesis that identical twins show no inter-twin differences in cardiovascular structure or physiology in fetal life unless there has been twin-twin transfusion syndrome. DESIGN Unselected prospective case-control observational study of fetoplacental haemodynamics including echocardiography at a median of 24 (16.7 to 32.3) weeks, with postnatal confirmation of congenit...

OBJECTIVE The purpose of this study was to determine the long-term neurodevelopmental outcome in children after twin-to-twin transfusion syndrome. STUDY DESIGN Maternal and neonatal medical records of all twin-to-twin transfusion syndrome patients who were admitted to our center between 1990 and 1998 were reviewed. Neurologic and mental development at school age was assessed during a home vis...