Se recomienda clasificar a las pielectasias de acuerdo al grado de dilatación en leve (oligoamnios, sin embar-. Liquido amniotico. Polihidramnios – Oligohidramnios. Indice de Liquido Amniotico. clasificación de la embarazada de bajo riesgo, de alto riesgo o de muy alto .. Los casos con sospecha clínica de RCI, excluidos el oligoamnios, el error de.

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Universidad Industrial de Santander.

Amniocentesis by Annie Lucia Espinoza Justiniani on Prezi

During the fetoscopy, we identified an arterio-venous anastomosis with bidirectional flow, which is atypical in this type of dde unidirectionals and could represent a sign of ominous prognosis for the restricted twin.

We concluded that it was a case of MCDA twin pregnancy with selective IUGR type 2 and we decided to monitor her in one week with the high probability oligohidramnioss fetal surgery in case of deterioration of the small baby.

Influence of vasopressin in the pathogenesis of oligohydramnios- polyhydramnios in monochorionic twins.

Alfirevic Z, Neilson JP. Cra 27 calle 9.

Síndrome de transfusión fetofetal

Medwave Jul;12 6: Role of the fetal renin-angiotensin system. Staging of twin-twin transfusion syndrome.

The ultrasound findings that worsen the prognosis of a pregnancy complicated with sIUGR are the discrepancy in the EFW between the twins, Doppler of the umbilical artery and ductus venosus of the restricted foetus along with oligohydramnios, gestational age at the moment of the surgery and cervical length 7.

We consider important to communicate this case because, in addition to the ultrasound findings of ominous prognosis, we found also a fetoscopic sign that worsens the prognosis for the restricted foetus reflecting its critical ill condition: Fetal and neonatal hypertension in twin-twin transfusion syndrome: Placental sharing, birthweight discordance, and vascular anastomoses in monochorionic diamniotic twin placentas.


This loss of blood into the small baby through the A-V anastomosis causes a reduced oxygenated blood flow to the healthy baby. Obstetric and perinatal outcomes from the australian and new zealand twin-twin transfusion syndrome registry. Frequency, distribution, and theoretical mechanisms of hematologic and weight discordance in monochorionic twins. Fetal membrane healing after spontaneous and iatrogenic membrane rupture: A sample of amniotic fluid was obtained for karyotype that turned out to be normal.

Among these complications we have the twinto-twin transfusion syndrome, the selective fetal growth restriction, the twin anaemia polycythemia sequence, the twin reversed arterial perfusion sequence and the monoamniotic pregnancy 1.

Doppler ultrasonography in high risk pregnancies Systematic review with meta analysis. Pregnancy and infant outcome of 80 consecutive cord coagulations in complicated monochorionic multiple pregnancies. Monochorionic pregnancies pose a great challenge for the fetal medicine specialist in terms of prevention, diagnosis and management due to the shared placental circulation by both twins. The cervix was long and closed, no funnelling, and measured 30 mm Figure 5.

Interventions for the treatment of twin-twin transfusion syndrome.

A woman with a monochorionic diamniotic twin pregnancy was referred to our Centre due to a discrepancy in size between the foetuses. The value of twin surveys in the study of malformations.

It was born at 34 weeks and 4 days by elective caesarean section due to prolonged premature rupture of membranes, oligohydramnios and breech presentation, weighting 2 grams and without any complication.


Therefore, we considered necessary to burn this anastomo sis in order to protect the blood flow into the big baby and avoid any risk of mental handicap.

Twin-to-twin transfusion syndrome results from dynamic asymmetrical reduction in oligohkdramnios anastomoses: Hydrostatic and osmotic pressure gradients produce manifestations of fetofetal transfusion syndrome in a computerized model of monochorial twin pregnancy.

Twin-twin transfusion syndrome with only superficial placental anastomoses: Considering the deterioration of the small twin amniotic fluid and Dopplers and its high chance of intrauterine demise, we decided to perform the fetal surgery mainly to protect the wellbeing of the healthy baby thus avoiding the consequent exsanguination of this twin through the placen-tal anastomoses. Jaypee Brothers Medical Publishers Ltd; The reason was a marked discrepancy in the growth of both twins Figure 1 and abnormal Dopplers in the small twin.

And second, an effective ultrasound-fetoscopic correlation that let us assess the progression of the disease and decide the most appropriate moment to intervene considering the ultrasound and feto scopic findings already described and yet to be studied. Selective intrauterine growth restriction in monochorionic diamniotic twin pregnancies. The fetoscopic surgery was performed uneventfully, with local anaesthesia and without any maternal complication.

oligohidrsmnios Am J Obstet Gynecol. Semin Fetal Neonatal Med. Epub 11 May Endoscopic laser surgery versus serial amnioreduction for severe twin-to-twin transfusion syndrome. Chile Medwave Oct;8