Vascular limb occlusion in twin-twin transfusion syndrome (TTTS): Case series and literature review

Susanne Schrey, Agnes Huber, Kurt Hecher, Rubén Quintero, Fawaz Alkazaleh, Kenneth J. Moise, John R. Allbert, Carol Schneider, Mario Palermo, Yoav Yinon, Ramen H. Chmait, Rory Windrim, Greg Ryan

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: The purpose of this study was to evaluate the phenomenon of vascular ischemic limb necrosis in twin-twin transfusion syndrome (TTTS). Study Design: This was a multicenter retrospective review of ischemic limb necrosis in patients with TTTS. Results: Twenty cases of fetal ischemic limb necrosis in association with TTTS were identified from 10 fetal medicine centers. The recipient was affected in 19 cases, and the lower limb was affected in 17 cases. The extent of the damage correlated with TTTS severity. Eighty percent of limb defects (16/20) clearly were unrelated to laser treatment (3 cases untreated, 7 cases after amnioreduction, 6 cases present at time of laser). The recipient was relatively polycythemic in 5 of 7 cases in which neonatal or fetal hemoglobin/hematocrit levels were available. Conclusion: Ischemic limb necrosis is a rare complication of TTTS. The lesion is unrelated to therapy and may be the result of polycythemia, hypertension, and vasoconstriction.

Original languageEnglish
JournalAmerican Journal of Obstetrics and Gynecology
Volume207
Issue number2
DOIs
StatePublished - Aug 1 2012

Fingerprint

Fetofetal Transfusion
Blood Vessels
Extremities
Necrosis
Lasers
Fetal Hemoglobin
Polycythemia
Vasoconstriction
Hematocrit
Lower Extremity
Medicine
Hypertension
Therapeutics

Keywords

  • limb defect
  • limb necrosis
  • pregnancy
  • twin-twin transfusion syndrome (TTTS)

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Vascular limb occlusion in twin-twin transfusion syndrome (TTTS) : Case series and literature review. / Schrey, Susanne; Huber, Agnes; Hecher, Kurt; Quintero, Rubén; Alkazaleh, Fawaz; Moise, Kenneth J.; Allbert, John R.; Schneider, Carol; Palermo, Mario; Yinon, Yoav; Chmait, Ramen H.; Windrim, Rory; Ryan, Greg.

In: American Journal of Obstetrics and Gynecology, Vol. 207, No. 2, 01.08.2012.

Research output: Contribution to journalArticle

Schrey, S, Huber, A, Hecher, K, Quintero, R, Alkazaleh, F, Moise, KJ, Allbert, JR, Schneider, C, Palermo, M, Yinon, Y, Chmait, RH, Windrim, R & Ryan, G 2012, 'Vascular limb occlusion in twin-twin transfusion syndrome (TTTS): Case series and literature review', American Journal of Obstetrics and Gynecology, vol. 207, no. 2. https://doi.org/10.1016/j.ajog.2012.06.005
Schrey, Susanne ; Huber, Agnes ; Hecher, Kurt ; Quintero, Rubén ; Alkazaleh, Fawaz ; Moise, Kenneth J. ; Allbert, John R. ; Schneider, Carol ; Palermo, Mario ; Yinon, Yoav ; Chmait, Ramen H. ; Windrim, Rory ; Ryan, Greg. / Vascular limb occlusion in twin-twin transfusion syndrome (TTTS) : Case series and literature review. In: American Journal of Obstetrics and Gynecology. 2012 ; Vol. 207, No. 2.
@article{db75d7b472674c45b212feeafb1b15d9,
title = "Vascular limb occlusion in twin-twin transfusion syndrome (TTTS): Case series and literature review",
abstract = "Objective: The purpose of this study was to evaluate the phenomenon of vascular ischemic limb necrosis in twin-twin transfusion syndrome (TTTS). Study Design: This was a multicenter retrospective review of ischemic limb necrosis in patients with TTTS. Results: Twenty cases of fetal ischemic limb necrosis in association with TTTS were identified from 10 fetal medicine centers. The recipient was affected in 19 cases, and the lower limb was affected in 17 cases. The extent of the damage correlated with TTTS severity. Eighty percent of limb defects (16/20) clearly were unrelated to laser treatment (3 cases untreated, 7 cases after amnioreduction, 6 cases present at time of laser). The recipient was relatively polycythemic in 5 of 7 cases in which neonatal or fetal hemoglobin/hematocrit levels were available. Conclusion: Ischemic limb necrosis is a rare complication of TTTS. The lesion is unrelated to therapy and may be the result of polycythemia, hypertension, and vasoconstriction.",
keywords = "limb defect, limb necrosis, pregnancy, twin-twin transfusion syndrome (TTTS)",
author = "Susanne Schrey and Agnes Huber and Kurt Hecher and Rub{\'e}n Quintero and Fawaz Alkazaleh and Moise, {Kenneth J.} and Allbert, {John R.} and Carol Schneider and Mario Palermo and Yoav Yinon and Chmait, {Ramen H.} and Rory Windrim and Greg Ryan",
year = "2012",
month = "8",
day = "1",
doi = "10.1016/j.ajog.2012.06.005",
language = "English",
volume = "207",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Vascular limb occlusion in twin-twin transfusion syndrome (TTTS)

T2 - Case series and literature review

AU - Schrey, Susanne

AU - Huber, Agnes

AU - Hecher, Kurt

AU - Quintero, Rubén

AU - Alkazaleh, Fawaz

AU - Moise, Kenneth J.

AU - Allbert, John R.

AU - Schneider, Carol

AU - Palermo, Mario

AU - Yinon, Yoav

AU - Chmait, Ramen H.

AU - Windrim, Rory

AU - Ryan, Greg

PY - 2012/8/1

Y1 - 2012/8/1

N2 - Objective: The purpose of this study was to evaluate the phenomenon of vascular ischemic limb necrosis in twin-twin transfusion syndrome (TTTS). Study Design: This was a multicenter retrospective review of ischemic limb necrosis in patients with TTTS. Results: Twenty cases of fetal ischemic limb necrosis in association with TTTS were identified from 10 fetal medicine centers. The recipient was affected in 19 cases, and the lower limb was affected in 17 cases. The extent of the damage correlated with TTTS severity. Eighty percent of limb defects (16/20) clearly were unrelated to laser treatment (3 cases untreated, 7 cases after amnioreduction, 6 cases present at time of laser). The recipient was relatively polycythemic in 5 of 7 cases in which neonatal or fetal hemoglobin/hematocrit levels were available. Conclusion: Ischemic limb necrosis is a rare complication of TTTS. The lesion is unrelated to therapy and may be the result of polycythemia, hypertension, and vasoconstriction.

AB - Objective: The purpose of this study was to evaluate the phenomenon of vascular ischemic limb necrosis in twin-twin transfusion syndrome (TTTS). Study Design: This was a multicenter retrospective review of ischemic limb necrosis in patients with TTTS. Results: Twenty cases of fetal ischemic limb necrosis in association with TTTS were identified from 10 fetal medicine centers. The recipient was affected in 19 cases, and the lower limb was affected in 17 cases. The extent of the damage correlated with TTTS severity. Eighty percent of limb defects (16/20) clearly were unrelated to laser treatment (3 cases untreated, 7 cases after amnioreduction, 6 cases present at time of laser). The recipient was relatively polycythemic in 5 of 7 cases in which neonatal or fetal hemoglobin/hematocrit levels were available. Conclusion: Ischemic limb necrosis is a rare complication of TTTS. The lesion is unrelated to therapy and may be the result of polycythemia, hypertension, and vasoconstriction.

KW - limb defect

KW - limb necrosis

KW - pregnancy

KW - twin-twin transfusion syndrome (TTTS)

UR - http://www.scopus.com/inward/record.url?scp=84864414423&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864414423&partnerID=8YFLogxK

U2 - 10.1016/j.ajog.2012.06.005

DO - 10.1016/j.ajog.2012.06.005

M3 - Article

C2 - 22840724

AN - SCOPUS:84864414423

VL - 207

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 2

ER -