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  • Crombleholme, Timothy M.  (3)
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  • 1
    Online Resource
    Online Resource
    Twin-to-Twin Transfusion Syndrome
    American Academy of Pediatrics (AAP) ; 2008
    In:  NeoReviews Vol. 9, No. 9 ( 2008-09-01), p. e370-e379
    Details
    In: NeoReviews, American Academy of Pediatrics (AAP), Vol. 9, No. 9 ( 2008-09-01), p. e370-e379
    Abstract: Twin-to-twin transfusion syndrome (TTTS) may be acute or chronic, but chronic TTTS complicates 10% to 20% of monochorionic twin gestations and has an 80% to 100% mortality rate if severe and left untreated. Both types are due to the presence of placental anastomoses between the two twins, but the mechanisms involved in the development of chronic TTTS are particularly complex and incompletely understood. Many of the apparent pathogenic mechanisms have implications for the appearances and cardiovascular and physiologic disturbances of neonates born following this intrauterine condition and their response to treatment. We present an update in the pathogenesis of TTTS that includes an overview of the placental features, fetal adaptive and maladaptive responses, and molecular mechanisms involved in the development of TTTS.
    Type of Medium: Online Resource
    ISSN: 1526-9906
    URL: Article
    DOI: 10.1542/neo.9-9-e370
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2008
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Twin-to-Twin Transfusion
    American Academy of Pediatrics (AAP) ; 2008
    In:  NeoReviews Vol. 9, No. 9 ( 2008-09-01), p. e393-e398
    Details
    In: NeoReviews, American Academy of Pediatrics (AAP), Vol. 9, No. 9 ( 2008-09-01), p. e393-e398
    Abstract: The high morbidity and mortality rates of twin-to-twin transfusion syndrome (TTTS) generally are related to sequelae of cardiovascular dysfunction or vascular disruption. Neurologic sequelae associated with TTTS are emerging concerns for survivors. A variety of clinical interventions, including amnioreduction, microseptostomy of the inter-twin membrane, and fetoscopic laser photocoagulation of placental anastomoses, have been used alone or in sequence to reduce the rates of mortality and morbidity. Because many of these specialized interventional procedures are performed at select centers in the United States, women may be treated at considerable distance from their primary obstetric care institutions and later return to deliver at their local facilities. Neonatologists may be unfamiliar with the relative efficacies and outcomes of the interventional procedures. In this review, we present a focused summary of the neurodevelopmental outcomes associated with these antenatal treatments.
    Type of Medium: Online Resource
    ISSN: 1526-9906
    URL: Article
    DOI: 10.1542/neo.9-9-e393
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2008
    Location Call Number Limitation Availability
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Twin-to-Twin Transfusion Syndrome
    American Academy of Pediatrics (AAP) ; 2008
    In:  NeoReviews Vol. 9, No. 9 ( 2008-09-01), p. e380-e392
    Details
    In: NeoReviews, American Academy of Pediatrics (AAP), Vol. 9, No. 9 ( 2008-09-01), p. e380-e392
    Abstract: Most anomalies seen in fetuses and neonates who have chronic twin-to-twin transfusion syndrome (TTTS) represent sequelae of cardiovascular dysfunction or vascular disruption. The placental examination can provide critical information to the neonatologist caring for infants who have a history of TTTS, especially in instances wherein the twins are not necessarily growth-discordant but have cardiovascular or renal dysfunction or neuropathologic findings. In this review, we present an updated discussion of the fetal and neonatal pathologies and adverse sequelae associated with TTTS and advances in antenatal diagnosis and clinical interventions for monochorionic gestations complicated by TTTS. We also present highlights of the placental examination so the neonatologist can inspect the placenta at the time of delivery and possibly gain insights that may affect patient care.
    Type of Medium: Online Resource
    ISSN: 1526-9906
    URL: Article
    DOI: 10.1542/neo.9-9-e380
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2008
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
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