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Extrauterine twin‐twin transfusion syndrome after birth in conjoined twins
Author(s) -
Shyu M.K.,
Shih J.C.,
Lee C.N.,
Wu C.C.,
Jou H.J.,
Hsieh F.J.,
Chang M.H.,
Tsou Yau K.I.,
Teng R.J.,
Lin G.J.,
Li Y.W.
Publication year - 1995
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.1995.06060447.x
Subject(s) - medicine , conjoined twins , twin to twin transfusion syndrome , hypervolemia , shunting , twin twin transfusion syndrome , obstetrics , hypovolemia , obstetrics and gynaecology , exchange transfusion , surgery , fetus , pregnancy , cardiology , pediatrics , anesthesia , blood volume , biology , genetics
Cross‐circulation of conjoined twins in utero has been demonstrated and the extent of its severity has varied. Significant ‘extrauterine’ twin‐twin transfusion syndrome after birth, however, caused by an unbalanced shunting within the circulation has not been reported. In a case of omphalopagus conjoined twins complicated by hypovolemia in one twin and hypervolemia in the other, we demonstrated by color Doppler imaging an aberrant vessel from the hepatic artery of one twin to the hepatic vein of the other. Unbalanced shunting through this aberrant vessel was suspected and urgent separation of the conjoined twins was undertaken. Circulatory changes after birth leading to ‘extrauterine twin‐twin transfusion syndrome’ are discussed. A possible explanation of the pathophysiology of intrauterine twin‐twin transfusion syndrome is also given. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology