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Re: Twin Transfusion SyndromeFrom: Carlos Rubio (crubiol@meditex.es)Fri Oct 25 04:34:55 1996
Carlos Rubio wrote: > > Carlos Rubio wrote: > > > > Carlos Rubio wrote: > > > > > > Carlos Rubio wrote: > > > > > > > >I am seeking for opinions regarding a case of Tw-Tw-Transfusion Synd. She is 22 y.o. G1 P0.with an spontaneous pregnancy. I scanned her > at 8 > > > weeks and a diagnosis of monochorionic diamniotic twin pregnancy was > > > made. Another scan at 12 weeks showed two fetuses with a nuchal > > > translucency of 1.2 mm in both. There was no diference in the CRL > > > measurement. At 16+4 weeks she was complaining of excesive weight gain and abdominal distension. A repeated scan showed the typical > findings of > > the above named syndrome: stuck twin in the anterior wall of the > > amniotic cavityinside an oligoamniotic sac and without a visible bladder > > and fetal biometry below the 5th centile and estimated fetal weight of > > 107 grams.Normal anatomy and reduced fetal movements. The recipient twin > > had a polyhidramniotic sac and was growing over the 95 centile for the > > gestational age, showed an enlarged bladder and the estimated fetal > > weight was 165 grams. A diagnosis of Tw-Tw Tr. Syndrome was made and she > > was booked for another scan at 19+3 weeks. Yesterday I found that the > > stuck twin had better movements,the fetus was less "attached" to the > > anterior wall, the bladder was seen , the fetal biometry was still below > > the 5th centile for the GA and the amniotic fluid of his sac was > > increased (in relation of the previous scan) with a good visualisation > > of the amniotic membrane separated from the fetus. The recipient twin > > was growing above the 95th centile, the bladder had a normal size and > > the amniotic fluid was normal but I found an extremely enlarged stomach > > in this twin. > > Now my questions are: > > Is it possible that the transfusion is resolving spontaneously ? > > What´s the significance of that dilated stomach ? > > Could it be due to the previous polyhidramnios and the fetus now is > > swallowing more as a compensating mechanism ?Thank you all in advance for your help>
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