The Experts below are selected from a list of 1212 Experts worldwide ranked by ideXlab platform
Xiaodong Wang - One of the best experts on this subject based on the ideXlab platform.
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conjoined twins in dichorionic diamniotic Triplet Pregnancy a report of three cases and literature review
BMC Pregnancy and Childbirth, 2021Co-Authors: Hongyan Liu, Chunyan Deng, Hua Liao, Xiaodong WangAbstract:Background Conjoined twins are a rare and serious complication of monochorionic twins. The total incidence is 1.5 per 100,000 births, and about 50% are liveborn. Prenatal screening and diagnosis of conjoined twins is usually performed by ultrasonography. Magnetic resonance imaging can be used to assist in the diagnosis if necessary. Conjoined twins in dichorionic diamniotic Triplet Pregnancy are extremely rare. Case presentation We reported three cases of dichorionic diamniotic Triplet Pregnancy with conjoined twins. Due to the poor prognosis of conjoined twins evaluated by multidisciplinary teams, selective termination of conjoined twins was performed in three cases. In case 1, selective reduction of the conjoined twins was performed at 16 gestational weeks, and a healthy female baby weighing 3270 g was delivered at 37 weeks. In case 2, the conjoined twins were selectively terminated at 17 weeks of gestation, and a healthy female baby weighing 2760 g was delivered at 37 weeks and 4 days. In case 3, the conjoined twins were selectively terminated at 15 weeks and 2 days, and a healthy female baby weighing 2450 g was delivered at 33 weeks and 6 days. The babies of all three cases were followed up and are in good health. Conclusion(s) Surgical separation is the only treatment for conjoined twins after birth. Early determination of chorionicity and antenatal diagnosis of conjoined twins in Triplet gestations are critical for individualized management options and the prognosis of normal Triplets. Expecting parents should be extensively counseled by multidisciplinary teams. If there are limitations in successful separation after birth, early selective termination of the conjoined twins by intrathoracic injection of potassium chloride may be a procedure in dichorionic diamniotic Triplet Pregnancy to improve perinatal outcomes of the normal Triplet.
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intrafetal laser therapy in a monochorionic diamniotic Triplet Pregnancy with two acardiac fetuses a case report and literature review
BMC Pregnancy and Childbirth, 2021Co-Authors: Guiqiong Huang, Hua Liao, Xiaodong WangAbstract:Monochorionic diamniotic Triplet pregnancies are rare. Twin reversed arterial perfusion sequence in monochorionic Triplet pregnancies is extremely rare, and it is associated with high perinatal morbidity and mortality rates in the “pump fetus.” We reported a case of monochorionic diamniotic Triplet Pregnancy with twin reversed arterial perfusion sequence, including two acardiac fetuses sharing a single amniotic sac and a normal fetus in another amniotic sac. Due to rapid growth of the acardiac fetuses, intrafetal laser therapy was performed in both of them under ultrasound guidance at 15 weeks +5 days. Subsequently, regular and careful antenatal care including fetal ultrasonography and doppler and fetal echocardiography was conducted. At 37 weeks +4 days, a healthy female baby weighing 2510 g was delivered. The baby was followed up and now at 11 months old is in good health. Twin reversed arterial perfusion sequence in monochorionic Triplet Pregnancy should be diagnosed early by ultrasound imaging during Pregnancy. Individualized management should be based on clinical conditions to improve the perinatal outcome of the pump twin. Intrafetal laser therapy could be an alternative procedure when intrauterine intervention is required.
Hongwei Wei - One of the best experts on this subject based on the ideXlab platform.
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monochorionic triamniotic Triplet Pregnancy complicated by twin reversed arterial perfusion sequence case report and literature review
American Journal of Perinatology Reports, 2017Co-Authors: Pingshan Pan, Guoyang Luo, Lu Tang, Jeanne D Rolle, Yuqin Qin, Quan Zeng, Jiangting Wei, Yuanfang Chen, Hongwei WeiAbstract:Background Monochorionic-triamniotic pregnancies are rare and fraught with complications. Case A case of monochorionic-triamniotic Triplet Pregnancy complicated by twin reversed arterial perfusion (TRAP) sequence is presented. The patient declined termination or selective fetal reduction. Triplet C was acardiac. At 24 weeks, Triplet B developed polyhydramnios. At 30 weeks, polyhydramnios was seen in all three amniotic sacs, but without signs of fetal hydrops and with normal Doppler velocimetry measurements in the umbilical artery, middle cerebral artery, and ductus arteriosus of Triplets A and B. At 322/7 weeks, the patient presented with preterm premature rupture of membranes and preterm labor. Two live male infants were delivered by cesarean delivery weighing 1,350 and 1,390 g, respectively; the acardiac fetus weighed 1,460 g. Pathology examination revealed a single placenta weighing1,250 g, with evidence of direct vascular connections between Triplets A and C as well as between Triplets A and B. Conclusion Monochorionic-triamniotic Triplet Pregnancy with TRAP sequence is rare. Although the risk of complications is high, such pregnancies can be managed conservatively in select cases.
J M G Van Vugt - One of the best experts on this subject based on the ideXlab platform.
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outcome of multifetal Pregnancy reduction in women with a dichorionic triamniotic Triplet Pregnancy to a singleton Pregnancy a retrospective nationwide cohort study
Fetal Diagnosis and Therapy, 2016Co-Authors: L Van De Mheen, Sheila M P Everwijn, Monique C Haak, Gwendolyn Manten, H A Zondervan, Maarten F C M Knapen, Melanie A J Engels, Jan Jaap H M Erwich, A Coumans, J M G Van VugtAbstract:Objective: To study the Pregnancy outcomes of women with a dichorionic triamniotic Triplet Pregnancy that was reduced to a singleton Pregnancy and to review the l
Pingshan Pan - One of the best experts on this subject based on the ideXlab platform.
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monochorionic triamniotic Triplet Pregnancy complicated by twin reversed arterial perfusion sequence case report and literature review
American Journal of Perinatology Reports, 2017Co-Authors: Pingshan Pan, Guoyang Luo, Lu Tang, Jeanne D Rolle, Yuqin Qin, Quan Zeng, Jiangting Wei, Yuanfang Chen, Hongwei WeiAbstract:Background Monochorionic-triamniotic pregnancies are rare and fraught with complications. Case A case of monochorionic-triamniotic Triplet Pregnancy complicated by twin reversed arterial perfusion (TRAP) sequence is presented. The patient declined termination or selective fetal reduction. Triplet C was acardiac. At 24 weeks, Triplet B developed polyhydramnios. At 30 weeks, polyhydramnios was seen in all three amniotic sacs, but without signs of fetal hydrops and with normal Doppler velocimetry measurements in the umbilical artery, middle cerebral artery, and ductus arteriosus of Triplets A and B. At 322/7 weeks, the patient presented with preterm premature rupture of membranes and preterm labor. Two live male infants were delivered by cesarean delivery weighing 1,350 and 1,390 g, respectively; the acardiac fetus weighed 1,460 g. Pathology examination revealed a single placenta weighing1,250 g, with evidence of direct vascular connections between Triplets A and C as well as between Triplets A and B. Conclusion Monochorionic-triamniotic Triplet Pregnancy with TRAP sequence is rare. Although the risk of complications is high, such pregnancies can be managed conservatively in select cases.
Waldo Sepulveda - One of the best experts on this subject based on the ideXlab platform.
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acardiac fetus complicating a Triplet Pregnancy management and outcome
Prenatal Diagnosis, 2009Co-Authors: Waldo Sepulveda, Amy E Wong, Juan Carlos Bustos, Ximena Flores, Juan L AlcaldeAbstract:Objective To report our experience with the management of Triplet pregnancies complicated by an acardiac fetus. Methods During the 5-year period from 2003 to 2008, five cases were identified. The prenatal sonographic findings, antepartum course, antenatal intervention if performed, and perinatal outcome of each case were reviewed. Results Four pregnancies were spontaneously conceived and one was achieved by in vitro fertilization. Three pregnancies were dichorionic and two were monochorionic, and two acardiac fetuses were part of a monoamniotic set. All cases underwent an early sonographic examination, but the diagnosis was only made in the first trimester in only two cases, as the acardiac fetus was overlooked or inaccurately identified as a dead fetus in the remaining three cases. Early fetal demise before 12 weeks occurred in a case of monochorionic-triamniotic Triplets. Percutaneous laser coagulation of the main intra-abdominal vessel was attempted at 17 weeks in two cases, with subsequent delivery after 34 weeks and perinatal survival of three of the four structurally normal fetuses. In the other two pregnancies which were managed expectantly, both were complicated by severe preterm delivery with perinatal survival of three of the four structurally normal fetuses. Overall, there were no survivors in one case, one twin survived in two cases, and two twins survived in the remaining two cases. None of the survivor had neurological sequelae. Conclusions The presence of an acardiac fetus in a Triplet Pregnancy carries a high risk for poor Pregnancy outcome, including fetal death and severe preterm labor. Prenatal intervention may be indicated in some cases, but does not prevent fetal death of the pump twin. Copyright © 2009 John Wiley & Sons, Ltd.
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conjoined twins in a Triplet Pregnancy early prenatal diagnosis with three dimensional ultrasound and review of the literature
Ultrasound in Obstetrics & Gynecology, 2003Co-Authors: Waldo Sepulveda, Hugo Roberto Munoz, J L AlcaldeAbstract:We report two cases of conjoined twins complicating a Triplet Pregnancy diagnosed by two-dimensional ultrasound in the first trimester and evaluated further by three-dimensional ultrasound. A review of the literature over the last 30 years revealed 11 other cases diagnosed prenatally by ultrasound. Overall, three (23%) of these 13 pregnancies were achieved by assisted reproductive techniques and 10 (77%) were diagnosed before 18 weeks. Four women opted for termination of the whole Pregnancy and three were managed expectantly, with two delivering before 32 weeks. Two monochorionic pregnancies underwent selective feticide with intrauterine demise of the non-conjoined fetus in both cases. All four dichorionic pregnancies undergoing selective termination or spontaneous embryo reduction to singleton in the first trimester resulted in term delivery of the non-conjoined fetus. The rare condition of conjoined twins in a Triplet Pregnancy poses a significant obstetric challenge from both diagnostic and management points of view. Accurate determination of chorionicity in these cases plays a critical role in determining management and outcome.
