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Accurate and Simple Evaluation of Vascular Anastomoses in Monochorionic Placenta using Colored Dye
09:52

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Published on: September 5, 2011

Thrombosis of anastomoses may affect the staging sequence of twin-twin transfusion syndrome

Jeroen P H M van den Wijngaard1, Michael G Ross, Martin J C van Gemert

  • 1Laser Center, Academic Medical Center-University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. j.p.vandenwijngaard@amc.uva.nl

Physics in Medicine and Biology
|February 26, 2008
PubMed

Twin-twin transfusion syndrome (TTTS) is a severe complication of monozygotic (identical) twins, which share one single monochorionic placenta. It is caused by placental anastomoses which link the two fetoplacental circulations of the twins and allow a chronic net inter-twin transfusion to develop between the fetuses. Clinical presentation of TTTS manifestations has been classified into five different stages. In this paper, we used our computational model of TTTS and examined the possible differences between chronic and rapidly increasing inter-twin transfusion in the simulated TTTS staging sequence. Our results suggest that rapid alterations in the net inter-twin transfusion, e.g. due to thrombosis of placental anastomoses, may produce a different staging sequence than in TTTS caused by chronic inter-twin transfusion. These results may aid an improved knowledge of TTTS pathophysiology under conditions of a rapidly changing cardiovascular function, and contribute to the planning of optimal intervention under such circumstances.

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