TY - JOUR
AU - Alkazaleh, F.
AB -  Objectives To evaluate the phenomenon of vascular limb occlusion in severe TTTS. Methods Seventeen cases of limb necrosis in association with severe TTTS were identified from seven fetal medicine centers, three of which are regional/national referral centers for laser treatment. Results No mother had a history of thrombophila or emboli. Mean gestation at TTTS diagnosis was 21.2 (range, 16–27) weeks. Nine recipients had cardiac dysfunction and three were hydropic. Therapy included: amnioreduction (AR) alone (seven), AR then laser (four), laser only (five) and termination without treatment (one). One was diagnosed on ultrasound before any intervention, five at fetoscopy, one on ultrasound after the intervention and 10 postnatally. Sixteen recipients were affected and one donor. Lower limbs were affected more severely and more often than upper (14:3;82%); 60% of lesions were right sided and one was bilateral. The extent of damage correlated with TTTS severity: 7/9 with severe fetal cardiac dysfunction had severe limb lesions. Of 14 lower limb lesions three involved feet/toes, seven were below and four were above the knee. All three available postnatal recipient hematocrits showed polycythemia. Conclusions Limb necrosis is a rare complication of severe TTTS, which is unrelated to treatment with laser or AR. 
TI - OC120: Vascular limb occlusion in severe twin–twin transfusion syndrome (TTTS)
JF - Ultrasound in Obstetrics & Gynecology
DO - 10.1002/uog.4226
DA - 2007-10-01
UR - https://www.deepdyve.com/lp/wiley/oc120-vascular-limb-occlusion-in-severe-twin-twin-transfusion-syndrome-Lx021mKoTn
SP - 404
EP - 404
VL - 30
IS - 4
DP - DeepDyve
ER -