Twin reversed-arterial-perfusion sequence is a serious complicationof monozygotic multiple gestations, affecting 1 percent of monozygotictwins, or 1 in 35,000 births1. It has been hypothesized thatin the presence of artery-to-artery and vein-to-vein anastomosesin a monozygotic placenta, blood is perfused by the hemodynamicallyadvantaged twin ("pump" twin) to the other twin ("recipient"twin) by means of retrograde flow2. Inadequate perfusion ofthe recipient twin is responsible for the development of a characteristicand invariably lethal set of anomalies, including acardia andacephalus. Typically, the pump twin is structurally normal,but it is at risk for in . . . [Full Text of this Article]
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From the Center for Fetal Diagnosis and Therapy, Fetal Endoscopy Program, Department of Obstetrics and Gynecology, Hutzel Hospital, Wayne State University, Detroit (R.A.Q., K.S.P., M.B., M.I.E., D.B.C., R.R.); Wyoming Valley Gyn Associates, Kingston, Pa. (H.R.); and the Perinatology Research Branch, National Institutes of Child Health and Human Development, Bethesda, Md. (R.R.).
Address reprint requests to Dr. Quintero at Hutzel Hospital, 4707 St. Antoine Blvd., Detroit, MI 48201.
Kunisaki, S. M., Jennings, R. W.
(2008). Fetal Surgery. J Intensive Care Med
23: 33-51
[Abstract]
Norwitz, E. R., Hoyte, L. P.J., Jenkins, K. J., van der Velde, M. E., Ratiu, P., Rodriguez-Thompson, D., Wilkins-Haug, L., Tempany, C. M.C., Fishman, S. J.
(2000). Separation of Conjoined Twins with the Twin Reversed-Arterial-Perfusion Sequence after Prenatal Planning with Three-Dimensional Modeling. NEJM
343: 399-402
[Full Text]
BRASSARD, M., FOURON, J.-C., LEDUC, L., GRIGNON, A., PROULX, F.
(1999). Prognostic Markers in Twin Pregnancies With an Acardiac Fetus. Obstet Gynecol
94: 409-414
[Abstract][Full Text]
Rodeck, C., Deans, A., Jauniaux, E.
(1998). Thermocoagulation for the Early Treatment of Pregnancy with an Acardiac Twin. NEJM
339: 1293-1295
[Full Text]
Holzgreve, W., Tercanli, S., Krings, W., Schuierer, G., Quintero, R. A.
(1994). A Simpler Technique for Umbilical-Cord Blockade of an Acardiac Twin. NEJM
331: 56-57
[Full Text]