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Re: Twin Transfusion Syndrome From: T-H Bui, Clinical Genetics, Karolinska Hospital (bui@gen.ks.se) Mon Oct 28 06:21:39 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: T-H Bui, Clinical Genetics, Karolinska Hospital: "Re: Drugs in Pregnancy" Previous message: Dr Vivienne Souter: "Re: Twin Transfusion Syndrome" At 11.19 1996-10-26 -0000, Dr Vivienne Souter wrote: >Has this been written up anywhere? I'd be interested to hear more. >(I would think this would be difficult if the membrane is tightly wrapped around the oligohydramnic, stuck twin.) We are trying to put the Karolinska and the Baylor cases together for a common publication. The Baylor series will be presented at the next SPO meeting if the paper is accepted ( we provided our data too late to Dr Belfort from Baylor to be included for that meeting). The first time I had heard of this approach for TTS was at a meeting in Newport, RI a couple of years ago for the 'Fetal medicine and Surgery Society'. In addition to the (early) cases from Baylor, there were a couple of cases presented by Dr Corrine Hubinont, now working at St. Luc University Hospital in Brussels, Belgium. The Belgian team accidentally damage the dividing membranes in a (first) case of oligo/poly and noticed that the amniotic fluid equilibrated in both sacs at followup. Their second case was done under direct fetoscopic control and a video was shown in Newport. I have not seen her cases published yet, but I know that Corrine is gathering and treating such cases in that way. Although we first thought that introducing an amniocentesis needle in the sac of the 'stuck' twin might be very difficult (that was the reason the Brussels' team used needle fetoscopy) in practice it was not so. The probable reason was first explained to me by Dr Belfort from Baylor. The sack surrounding the 'stuck' twin doesn't probably shrunk together, instead it is most probable that the expending sack of the polyhydramniotic twin flattened the sack of the 'stuck' twin at its periphery; this cannot be seen on ultrasound. If an amniocentesis is performed closed to the 'stuck' twin's sack but into the polyhydramniotic sack then a hole (or rather two) will be performed in the oligo sack. In two of our cases it is just what happened as we were doing serial taps for polyhydramnios. ***************************************************************** The-Hung Bui, M.D. Associate Head Physician -- Department of Clinical Genetics Karolinska Hospital S-171 76 Stockholm, Sweden phone: +46 8 729 4989 or 729 2472 (secretary) fax: +46 8 32 77 34 E-mail: bui@gen.ks.se or The-Hung.Bui@molmed.ki.se ****************************************************************** Next message: T-H Bui, Clinical Genetics, Karolinska Hospital: "Re: Drugs in Pregnancy" Previous message: Dr Vivienne Souter: "Re: Twin Transfusion Syndrome"

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