Fetal Limb Ischaemia in Twin-to-Twin Transfusion Syndrome
Objective. To describe the rare association between prenatal vascular limb occlusion and twin-to-twin transfusion syndrome. The Case. A woman with severe twin-to-twin transfusion syndrome was treated with fetoscopic laser ablation at 19-week gestation. At 27 weeks, the twins were delivered by an eme...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2013/278726 |
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| author | Mark Kilby Rachel Pounds Paul Mannix |
| author_facet | Mark Kilby Rachel Pounds Paul Mannix |
| author_sort | Mark Kilby |
| collection | DOAJ |
| description | Objective. To describe the rare association between prenatal vascular limb occlusion and twin-to-twin transfusion syndrome. The Case. A woman with severe twin-to-twin transfusion syndrome was treated with fetoscopic laser ablation at 19-week gestation. At 27 weeks, the twins were delivered by an emergency caesarean section. The right arm of twin 1, the recipient twin, was noted to be “ischaemic” and was later amputated. Conclusion. This case is unusual in that it affected the upper limb and there was no evidence of polycythaemia, which is a suggested pathological mechanism. It was initially thought that the limb damage was due to the laser ablation, but after discussion with the fetal medicine team vascular limb occlusion in association with twin-to-twin transfusion syndrome was considered. Limb ischaemia is a serious complication of twin-to-twin transfusion syndrome and is unrelated to any form of fetal therapy. Implications. Neonatologists and paediatricians need to be aware of this association as it has medicolegal implications and parents should be counselled as to the possible, albeit rare, occurrence, especially when twin-to-twin transfusion syndrome is of advanced stage at presentation. |
| format | Article |
| id | doaj-art-c62684b7d32b48c9bdcf3c69730bd360 |
| institution | Kabale University |
| issn | 2090-6803 2090-6811 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-c62684b7d32b48c9bdcf3c69730bd3602025-02-03T05:45:43ZengWileyCase Reports in Pediatrics2090-68032090-68112013-01-01201310.1155/2013/278726278726Fetal Limb Ischaemia in Twin-to-Twin Transfusion SyndromeMark Kilby0Rachel Pounds1Paul Mannix2School of Clinical & Experimental Medicine, College of Medical & Dental Sciences, University of Birmingham, Birmingham B15 2TT, UKSchool of Clinical & Experimental Medicine, College of Medical & Dental Sciences, University of Birmingham, Birmingham B15 2TT, UKSouthmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UKObjective. To describe the rare association between prenatal vascular limb occlusion and twin-to-twin transfusion syndrome. The Case. A woman with severe twin-to-twin transfusion syndrome was treated with fetoscopic laser ablation at 19-week gestation. At 27 weeks, the twins were delivered by an emergency caesarean section. The right arm of twin 1, the recipient twin, was noted to be “ischaemic” and was later amputated. Conclusion. This case is unusual in that it affected the upper limb and there was no evidence of polycythaemia, which is a suggested pathological mechanism. It was initially thought that the limb damage was due to the laser ablation, but after discussion with the fetal medicine team vascular limb occlusion in association with twin-to-twin transfusion syndrome was considered. Limb ischaemia is a serious complication of twin-to-twin transfusion syndrome and is unrelated to any form of fetal therapy. Implications. Neonatologists and paediatricians need to be aware of this association as it has medicolegal implications and parents should be counselled as to the possible, albeit rare, occurrence, especially when twin-to-twin transfusion syndrome is of advanced stage at presentation.http://dx.doi.org/10.1155/2013/278726 |
| spellingShingle | Mark Kilby Rachel Pounds Paul Mannix Fetal Limb Ischaemia in Twin-to-Twin Transfusion Syndrome Case Reports in Pediatrics |
| title | Fetal Limb Ischaemia in Twin-to-Twin Transfusion Syndrome |
| title_full | Fetal Limb Ischaemia in Twin-to-Twin Transfusion Syndrome |
| title_fullStr | Fetal Limb Ischaemia in Twin-to-Twin Transfusion Syndrome |
| title_full_unstemmed | Fetal Limb Ischaemia in Twin-to-Twin Transfusion Syndrome |
| title_short | Fetal Limb Ischaemia in Twin-to-Twin Transfusion Syndrome |
| title_sort | fetal limb ischaemia in twin to twin transfusion syndrome |
| url | http://dx.doi.org/10.1155/2013/278726 |
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