Separation of Conjoined Twins with the Twin Reversed-Arterial-Perfusion Sequence after Prenatal Planning with Three-Dimensional Modeling
Errol R. Norwitz, M.D., Ph.D., Lennox P.J. Hoyte, M.D., Kathy J. Jenkins, M.D., M.P.H., Mary E. van der Velde, M.D., Peter Ratiu, M.D., Diana Rodriguez-Thompson, M.D., M.P.H., Louise Wilkins-Haug, M.D., Ph.D., Clare M.C. Tempany, M.D., and Steven J. Fishman, M.D.
Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.
There are two congenital anomalies specific to multifetal pregnancies:twin reversed-arterial-perfusion sequence and conjoined twinning.The twin reversed-arterial-perfusion sequence is a rare complicationof monozygous twinning in which one fetus (the "pump" twin)perfuses the other fetus (the "perfused" twin), resulting inreversed flow in the umbilical vessels and multiple structuralanomalies, including acardia, in the perfused twin.1 It occursin fewer than 1 percent of pregnancies with monozygous twinsand in about 1 in 35,000 births overall.2,3 Conjoined twinningoccurs as a result of incomplete duplication of a single blastocystduring the process of monozygotic twinning.4 It is a . . . [Full Text of this Article]
Case Report
Discussion
Source Information
From the Departments of Obstetrics, Gynecology, and Reproductive Biology (E.R.N., L.P.J.H., D.R.-T., L.W.-H.) and Radiology (P.R., C.M.C.T.), Brigham and Women's Hospital and Harvard Medical School; and the Departments of Cardiology (K.J.J., M.E.V.) and Surgery (S.J.F.), Children's Hospital and Harvard Medical School — all in Boston.
Address reprint requests to Dr. Fishman at the Department of Surgery, Children's Hospital, 300 Longwood Ave., Boston, MA 02115, or at steven.fishman@tch.harvard.edu.
References
This article has been cited by other articles:
Andrews, R E, McMahon, C J, Yates, R W M, Cullen, S, de Leval, M R, Kiely, E M, Spitz, L, Sullivan, I D
(2006). Echocardiographic assessment of conjoined twins. Heart
92: 382-387
[Abstract][Full Text]
Shank, E., Manohar, N., Schmidt, U.
(2005). Anesthetic Management for Thoracopagus Twins with Complex Cyanotic Heart Disease in the Magnetic Resonance Imaging Suite. Anesth. Analg.
100: 361-364
[Abstract][Full Text]
Campion, E. W.
(2004). Medical Research and the News Media. NEJM
351: 2436-2437
[Full Text]
Frates, M. C., Kumar, A. J., Benson, C. B., Ward, V. L., Tempany, C. M.
(2004). Fetal Anomalies: Comparison of MR Imaging and US for Diagnosis. Radiology
232: 398-404
[Abstract][Full Text]
Annas, G. J.
(2001). Conjoined Twins -- The Limits of Law at the Limits of Life. NEJM
344: 1104-1108
[Full Text]
Tempany, C. M. C., McNeil, B. J.
(2001). Advances in Biomedical Imaging. JAMA
285: 562-567
[Abstract][Full Text]
Previous
Videos
