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Umbilical cord coagulation by operative microendoscopy at 16 weeks' gestation in an acardiac twin
Author(s) -
Hecher K.,
Hackeloer B. J.,
Ville Y.
Publication year - 1997
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.1469-0705.1997.10020130.x
Subject(s) - medicine , umbilical cord , fetoscopy , gestation , anastomosis , obstetrics and gynaecology , twin pregnancy , obstetrics , monochorionic twins , fetus , ultrasound , blood flow , hemodynamics , cord , surgery , pregnancy , cardiology , prenatal diagnosis , anatomy , radiology , genetics , biology
Twin reversed arterial perfusion (TRAP) sequence carries high mortality and morbidity in the normal twin due to a hemodynamic imbalance through the feto–fetal vascular anastomosis. This report describes the ultrasound features of TRAP in the first trimester and a new technique for selective fetocide in the early second trimester in monochorionic twin pregnancies complicated by the TRAP sequence. Laser coagulation of the umbilical cord of the acardiac twin was performed under sonoendoscopic control. The blood flow in the umbilical cord of the acardiac twin was successfully arrested and the survivor developed normally. TRAP sequence can be recognized in the first trimester and successfully arrested by microendoscopic surgery. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology