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Visualizing Prenatal Twin Anatomy: A Parent Education Resource for Twin‐Twin Transfusion Syndrome
Author(s) -
Castillo Christine Joy,
Lee Lisa MJ,
Behrendt Nicholas,
Marwan Ahmed
Publication year - 2019
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2019.33.1_supplement.444.29
Subject(s) - fetoscopy , medicine , obstetrics , prenatal diagnosis , fetus , pregnancy , genetics , biology
Twin‐twin transfusion syndrome (TTTS) is a complication occurring in 10–20% of monochorionic diamniotic multiple pregnancies characterized by unequal circulation due to placental anastomoses. Left untreated, chronic TTTS has an 80–100% mortality rate, with sequelae including cardiovascular, neurodevelopmental and renal anomalies in surviving infants. Prognosis is improved by timely diagnosis and intervention, with selective fetoscopic laser photocoagulation emerging as the front‐line treatment. Considering poor prognosis and the urgent need for invasive treatment, TTTS announcement is a traumatic event for expectant parents regardless of survival outcome, thus adequate support from their providers is essential. Parent perception of their care relies on receiving ample information, and while antenatal multidisciplinary consultations at fetal centers provide space for parent education, parents often have difficulty understanding the fetal and placental anatomy. Currently, at the Colorado Fetal Care Center, supplemental educational resources include 2D images and literature intended for a scientific audience. The objective of this project was to develop and implement an interactive 3D virtual model of TTTS during antenatal consultations to facilitate parent education. The model was developed from deidentified fetal MRI Digital Imaging and Communications in Medicine (DICOM) data demonstrating TTTS (COMIRB # 18‐1955). A total of 10 MRI datasets (6 with selective intrauterine growth restriction (SIUGR), 4 without SIUGR) were identified as possible candidates. One dataset was selected for model construction based on representation of the pathology. The DICOM data was segmented on 3D Slicer. The segmentations were imported into Blender for 3D rendering and to smooth artifacts, then published onto Sketchfab for user interaction. The tool was assessed by obstetric and surgical specialists for accuracy. By providing an anatomically accurate fetal, placental, and pathologic anastomosis visualization, this model can assist providers in demonstrating the diagnosis, explaining prognosis, and discussing potential treatment options. The new 3D, interactive virtual TTTS model has the potential to improve parents' experience by increasing patient knowledge and engaging them in the intervention planning required to optimize fetal outcomes. Further investigation is required to determine the efficacy and educational value of the model. This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .