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Re: FW: hydrocephalic twinFrom: Dr Ross Welch, UK (ross.welch@whnt.nhs.uk)Tue Jul 16 10:33:52 2002
Dear all I had a similar case last year. Monochorionic twins with evidence of twin to twin (fetofetal transfusion) with one fetus being acranic (the donor). These are very difficult to manage and really the only option is some form of direct cord coagulation of the affect fetus. We used a fetoscope to guide a 3mm biploar diathery forceys onto the affected cord and coaglated. This has been published by others. More recently others have published USS guided bipolar diathermy without the fetoscope. You cannot simply use intracardiac KCl unless you are sure they are dizygotic. If, as suggested by the history and images, they are monochorionic then it is important to prevent "back bleeding" from the normal twin to the abnormal hence cord coagulation is preferred approach. I look forward to hearing the outcome
-- Ross Welch
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