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Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas
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Monochorionic twins with ruptured vasa previa: double trouble!
D Papathanasiou1, R Witlox, D Oepkes
1Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
Velamentous cord insertion and vasa previa are common in monochorionic twins, risking fetal anemia and distress. Ruptured vasa previa can cause acute feto-fetal transfusion, severely impacting both twins.
Area of Science:
- Maternal-Fetal Medicine
- Perinatology
- Twin Gestation
Background:
- Velamentous cord insertion and vasa previa are more prevalent in monochorionic twins.
- These conditions increase the risk of adverse perinatal outcomes due to potential vessel rupture.
Observation:
- A case of monochorionic twins experiencing acute fetal distress due to undiagnosed ruptured vasa previa.
- Both neonates presented with severe anemia at birth.
Findings:
- Ruptured vasa previa in one twin led to acute feto-fetal transfusion via placental anastomoses.
- This transfusion resulted in severe hypovolemic shock and anemia in both fetuses.
Implications:
- Highlights the critical risk of acute feto-fetal transfusion in monochorionic twins with ruptured vasa previa.
- Emphasizes the need for heightened awareness of vasa previa and placental angioarchitecture in monochorionic pregnancies.
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