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Updated: Jun 24, 2026
Accurate and Simple Evaluation of Vascular Anastomoses in Monochorionic Placenta using Colored Dye
Published on: September 5, 2011
Residual anastomoses in twin-to-twin transfusion syndrome treated with selective fetoscopic laser surgery:
Enrico Lopriore1, Femke Slaghekke, Johanna M Middeldorp
1Department of Pediatrics, Division of Neonatology, Leiden University Medical Centre, Leiden, The Netherlands.
Objective:
To study the localization and size of residual anastomoses in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery and correlate the findings with outcome.
Study Design:
Placental injection in twin-to-twin transfusion syndrome placentas treated with laser was performed by using colored dye.
Results:
A total of 77 twin-to-twin transfusion syndrome placentas were included in the study. Residual anastomoses (n = 48) were found in 32% (25/77) of lasered placentas. Most residual anastomoses were localized near the margin of the placenta. The majority of residual anastomoses (67%; 32/48) were very small (diameter, < 1 mm). Eleven of the 25 cases (44%) in the residual anastomoses group developed twin anemia-polycythemia sequence.
Conclusion:
Most residual anastomoses in twin-to-twin transfusion syndrome placentas treated with laser are very small and localized near the placental margin. Almost half of cases with residual anastomoses developed twin anemia-polycythemia sequence after laser surgery.
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