Ablation of acardiac twin by alcohol injection into the intra-abdominal umbilical artery.
Obstet Gynecol
; 86(4 Pt 2): 680-1, 1995 Oct.
Article
em En
| MEDLINE
| ID: mdl-7675412
ABSTRACT
BACKGROUND:
Twin reversed arterial perfusion sequence is a rare complication of monochorionic twinning, in which the normal pump twin perfuses the abnormal acardiac twin in a reversed fashion via an artery-to-artery placental anastomosis. Mortality in the normal twin exceeds 50% as a result of preterm labor, polyhydramnios, and congestive heart failure. CASE A twin pregnancy complicated by the twin reversed arterial perfusion sequence developed early hemodynamic decompensation in the pump twin with increasing size of the acardiac twin. Ablation of the acardiac twin at 23 weeks' gestation was achieved successfully by injecting 1 mL of absolute alcohol into the intra-abdominal portion of the single umbilical artery.CONCLUSION:
Direct ultrasound-guided intravascular injection of absolute alcohol is an easy and straightforward technique to occlude circulation to the acardiac twin. This vessel can be identified easily by color Doppler ultrasonography away from the main venous trunk. Selection of this target, rather than occlusion at the level of the umbilical cord, could reduce the risks of cord accidents and inadvertent intravenous injection of the ablative material.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Gêmeos
/
Artérias Umbilicais
/
Redução de Gravidez Multifetal
/
Etanol
Tipo de estudo:
Prognostic_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Ano de publicação:
1995
Tipo de documento:
Article