Placental injection studies in twin gestation

Area of Science:

• Obstetrics and Gynecology
• Perinatology
• Fetal Medicine

Background:

• Vascular communication between placental vessels is a known complication in fused placental masses during twin gestation.
• Anastomotic channels in fused placentas can potentially lead to twin-twin transfusion syndrome (TTTS).
• Understanding the incidence of these communications and TTTS is crucial for accurate diagnosis and management.

Purpose of the Study:

• To determine the incidence of vascular communication in fused twin placentas.
• To assess the frequency of twin-twin transfusion syndrome in relation to placental vascular communication.
• To evaluate the role of chorionicity determination in preventing misdiagnosis of intrauterine growth retardation.

Main Methods:

• A study involving 278 twin pairs was conducted.
• Placentas were inspected to identify fused placental masses and vascular communications (anastomoses).
• Chorionicity was determined by placental inspection.

Main Results:

• Vascular communication was found almost universally in monochorionic placentation.
• Anastomotic communication was very rare in dichorionic placentas.
• Twin-twin transfusion syndrome occurred uncommonly, despite the high frequency of cross-placental vascular communication.

Conclusions:

• Monochorionic twin placentas frequently exhibit vascular anastomoses.
• The occurrence of twin-twin transfusion syndrome is less frequent than the incidence of vascular communication.
• Determining chorionicity via placental inspection is vital to avoid misdiagnosing intrauterine growth retardation in twins.