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Transfusion Syndrome (transfusion + syndrome)

Distribution by Scientific Domains
Medical Sciences65%
Distribution within Medical Sciences
Obstetrics & Gynecology61%
Pediatrics38%

Kinds of Transfusion Syndrome

  • twin transfusion syndrome
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  • twin-to-twin transfusion syndrome
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    Selected Abstracts

    Cardiac outcomes of hydrops as a result of twin,twin transfusion syndrome treated with laser surgery

    JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1-2 2009
    Peter H Gray
    Aim: To determine cardiac outcomes of foetal hydrops as a result of twin,twin transfusion syndrome treated with laser surgery. Methods: Hydrops identified in 16 recipient foetuses with twin,twin transfusion syndrome was treated with laser ablation surgery to anastomotic vessels. Prior to laser surgery, the foetuses were assessed by echocardiography for cardiac abnormalities and ventricular and valvular dysfunction. After delivery, echocardiography was performed on 15 of the 16 newborn infants. Results: Foetal echocardiography indicated impaired biventricular function in the 16 hydropic foetuses. Five foetuses had little or no forward flow through the pulmonary valve, while four had pulmonary regurgitation. Following laser surgery performed at a mean of 22.9 weeks gestation, hydrops resolved in all cases. Delivery occurred at a mean of 33.6 weeks gestation. Post-natal echocardiography revealed cardiac abnormalities in five neonates, of whom three had right ventricular outflow tract obstruction. One preterm infant with severe pulmonary stenosis died with intractable cardiac failure. Conclusion: The majority of hydropic infants with twin,win transfusion syndrome have normal cardiac outcomes following intrauterine laser surgery. As up to one-third may have cardiac abnormalities, cardiological monitoring is recommended during the first year of life. [source]

    Idiopathic arterial calcification in infancy with twin,twin transfusion syndrome

    PEDIATRICS INTERNATIONAL, Issue 4 2003
    Noboru Inamura
    No abstract is available for this article. [source]

    Increased concentrations of antiangiogenic factors in mirror syndrome complicating twin-to-twin transfusion syndrome

    PRENATAL DIAGNOSIS, Issue 4 2010
    Dr Federico Prefumo
    No abstract is available for this article. [source]

    Second-trimester maternal serum screening for Down syndrome in twin-to-twin transfusion syndrome

    PRENATAL DIAGNOSIS, Issue 8 2009
    Nathalie Sermondade
    No abstract is available for this article. [source]

    Resolution of mirror syndrome after successful fetoscopic laser photocoagulation of communicating placental vessels in severe twin,twin transfusion syndrome

    PRENATAL DIAGNOSIS, Issue 12 2008
    Masakazu Matsubara
    No abstract is available for this article. [source]

    Twin,twin transfusion syndrome: mathematical modelling

    PRENATAL DIAGNOSIS, Issue 4 2008
    Jeroen P. H. M. van den Wijngaard
    Abstract Twin,twin transfusion syndrome (TTTS) represents a pregnancy complication with a high risk for perinatal mortality and postnatal morbidity. Mathematical models have been utilized to examine the mechanisms of disease and potential treatment modalities. We developed four consecutive models based on pathophysiology mechanisms. Conceptually, these models remained simple, but with increased complexity in details. We present our models tutorially with the necessary equations expressed in words. The aetiology of TTTS was related to AV anastomoses from donor to recipient and their growth commensurate with placental growth. We assessed that natural growth of placenta and foetuses causes the diameter and length of the AV, as well as the AV's pressure gradient, to increase proportional to gestational age. The AV transfusion then increases faster than natural foetal growth. A progressively increasing discordance subsequently develops, not compensated for by foetal growth. A simulation is performed to show how this discordance in blood volumetric development causes successive discordances in other functions, particularly renal, circulatory, and cardio-vascular, resulting in disease progression to the various stages of TTTS. In conclusion, mathematical modelling of TTTS has provided an understanding of the sequence of events that leads to the various presentations of TTTS stages as well as the efficacy of therapies. Copyright © 2008 John Wiley & Sons, Ltd. [source]

    Hemodynamic changes with phenotype reversal during pregnancy in twin,twin transfusion syndrome

    PRENATAL DIAGNOSIS, Issue 10 2004
    G. C. Meyberg-Solomayer
    Abstract Objectives We report an atypical case of twin,twin transfusion syndrome (TTTS) in monochorionic-diamniotic twins with arterio-arterial anastomoses in which the former donor became the recipient during pregnancy. Methods Serial sonographic monitoring was performed. Results There was a phenotype reversal in TTTS concerning growth and amniotic fluid ending at 27 weeks, with the dominance of the former smaller donor. Doppler sonography changed from absent enddiastolic flow of the donor to normal values in both twins. The new recipient showed transient ascites, the now smaller actual donor (former recipient) developed progressive cardiomegaly, hypertrophy of the myocardium and mitral and tricuspid insufficiency at 29 weeks. Doppler sonography in the new donor deteriorated to highly pathologic flow in the venous system, leading to cesarean section. The donor fetus died 12 h after delivery because of myocardial decompensation. The recipient did very well and was discharged 8 weeks later from the neonatology unit. Conclusion This atypical course shows the importance of serial sonographic monitoring in pregnancies with TTTS. Copyright © 2004 John Wiley & Sons, Ltd. [source]

    Immediate outcome of twin,twin transfusion syndrome following selective laser photocoagulation of communicating vessels at the NSW Fetal Therapy Centre

    AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2010
    N. MERIKI
    Objective:, To audit the outcome for laser photocoagulation for twin,twin transfusion syndrome (TTTS) as managed by the New South Wales Fetal Therapy Centre (NSW FTC). Methods: A retrospective cohort study. Outcome data were reviewed for referrals between June 2003 and June 2008. The outcome measures included the severity of TTTS at presentation, delivery details (gestational age at delivery, birth weight and Apgar score at 5 min) and perinatal outcome (spontaneous miscarriage, premature rupture of membranes, intrauterine death, placental abruption and neonatal death). Results: Seventy-nine patients were treated with laser therapy for stage I,IV TTTS (median stage III). Median gestational age at treatment was 20 weeks (range 16,25). Median gestational age at delivery was 32 weeks (range 24,40). Survival of at least one baby in this study was 90.7% (88.9% for anterior and 92.1% for posterior placenta), and of both babies was 60.0%. Median birth weight was 1788 g (range 490,3695). Median Apgar score was nine at 5 min. Three women required repeat laser treatment for persistent TTTS. Conclusions: Selective laser photocoagulation of communicating vessels remains the treatment of choice for TTTS. Referrals to the NSW FTC have increased from five cases in the last half of 2003, to 18 cases in the first half of 2008. Local outcome figures at least equal any in the published international literature and support a continued policy of centralised care in Australia. A two-year follow-up study on neonatal outcome for survivors is underway. [source]

    Selective fetoscopic laser ablation in 100 consecutive pregnancies with severe twin,twin transfusion syndrome

    AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2009
    Robert B. CINCOTTA
    Aims: To report the perinatal outcomes of a large series of twin pregnancies with severe twin,twin transfusion syndrome (TTTS) managed with laser ablation surgery in an Australian tertiary perinatal centre and to compare the outcome with other large cohorts. Methods: The outcomes of 100 consecutive pregnancies with severe TTTS managed with selective fetoscopic laser ablation from March 2002 to June 2007 were examined. Survival and neonatal morbidity were analysed. Comparisons were made with the results from other studies of laser surgery with at least 100 pregnancies. Results: There were 100 women with TTTS treated with laser ablation; 34 stage II, 44 stage III and 22 at stage IV. Median gestation at time of laser was 21 weeks (range 18,28) and median gestation at delivery was 31 weeks (range 20,39). Overall perinatal survival rate was 151 of 200 (75.5%). Eighty five per cent had one or more surviving twins. The survival rate for stage IV TTTS was 88.6%, significantly better than for stage II (69.1%) and stage III (73.9%) pregnancies. The perinatal mortality rate for donors (30%) was not significantly different from recipients (19%), but the fetal death rate for donors was significantly greater than that for recipients (P = 0.03). Severe cerebral abnormalities were present in only 2.8% of newborns. The overall survival rate was comparable to other large series. Conclusions: These results for the management of severe TTTS are comparable to the best reported international series. Long-term follow-up is required and more research needs to be undertaken to further improve these results. [source]

    Maternal pseudo primary hyperaldosteronism in twin-to-twin transfusion syndrome

    BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 1 2007
    IL Gussi
    Objective, To monitor changes in the maternal renin,angiotensin,aldosterone system following laser therapy and amnioreduction in severe twin-to-twin transfusion syndrome (TTTS). Design, Observational prospective study. Setting, Single university hospital in Poissy, France. Population, Sixty cases of TTTS at 16,26 weeks of gestation. Method, Maternal blood sampling before, 6 and 24 hours following the procedure. Main outcome measures, Plasma levels of aldosterone, renin, angiotensin II (AII), atrial natriuretic peptide (ANP), vasopressin, sodium, potassium and plasma proteins together with full blood count were measured before, 6 and 24 hours following the procedure. Results, TTTS is associated with maternal hyperaldosteronism dissociated from renin,angiotensin changes. Correcting TTTS by placental surgery and amnioreduction triggers incomplete correction of hyperaldosteronism, as early as 6 hours following the procedure, without changes in AII but an increase in the levels of ANP in plasma. Electrolyte concentrations remained stable despite haemodilution, while vasoactive hormone levels such as that of vasopressin remained unchanged. Conclusion, Mechanisms involved in marked fluid retention in TTTS are rapidly corrected by laser therapy followed by amnioreduction while maintaining electrolyte homeostasis. [source]

    Outcome for children born after in utero laser ablation therapy for severe twin-to-twin transfusion syndrome

    BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 12 2001
    A.G. Sutcliffe
    Objective To examine the postnatal development of a group of children born after in utero laser ablation therapy for severe twin-to-twin transfusion syndrome. Design Retrospective cohort outcome study involving assessment of neurodevelopment and physical well being. Setting Harris Birthright Centre, King's College Hospital, London. Participants Twins and singleton survivors treated via laser ablation therapy for twin-to-twin transfusion syndrome over a four-year period. Methods Of 54 families contacted to participate in the study, who had been treated for twin-to-twin transfusion syndrome during a four-year period, 24 families attended for paediatric assessment; 12 pairs of twins and 12 singleton survivors were assessed for perinatal, neurological and neurodevelopmental outcome using the Griffiths scales of mental development. A further 20 families were assessed via a proforma after contact with their general practitioner. A comparison of these groups showed no significant differences in sociodemographic factors or severity of disease between responders (44 families, 81.5%) and non-responders (10 families). Results The group of children assessed by a paediatrician had low birthweight (1619g donor, 1814g recipient, 1877g singleton) and had been born preterm (33 weeks twins, 31.2 weeks singleton) with attendant increased resuscitation, neonatal unit admission (mean 40 days) and instrumental delivery. Mean Griffiths scores were within the normal range of ability (91.2 donor vs 97.7 recipient and 101.6 singletons) with the only significant difference being in the locomotor subscale where donor (82.6) and recipient (85.3) were less than singletons: -99.1 (P<0.05). There was no cerebral palsy in the singleton survivors, but there were five cases in the twin group. All except one affected child (with quadriplegia) had mean Griffiths scores in the normal range. In the GP proforma group there was one case, in a twin, of cerebral palsy. Conclusion The overall cerebral palsy rate was 9%: 0% in the singleton survivors group and 13.3% in the twin survivors group. This pilot data highlights the need for careful long term follow up of children affected by twin-to-twin transfusion syndrome. [source]

    Childhood cardiac function after twin-to-twin transfusion syndrome , a 10-year follow up

    ACTA PAEDIATRICA, Issue 9 2009
    CP Halvorsen
    Abstract Aim:, To perform a 10-year follow up of cardiac structure and function after twin-to-twin transfusion syndrome (TTTS) , a severe foetal circulatory complication associated with myocardial hypertrophy in the recipient twin. Methods:, Cardiac dimensions, systolic and diastolic function as assessed by echocardiography including flow and tissue Doppler velocimetry in 22 healthy survivors of TTTS with a mean age of 9.6 (7.2,11.8) years. Results:, The donor and recipient twin did not show any differences in end-diastolic ventricular size, interventricular septum thickness, diameter of right ventricular outflow tract, cardiac valves, coronary arteries or in systolic blood flow velocities. However, compared with the donors, the recipients had significantly lower E/A ratios because of lower E-waves in both mitral (,0.15 ± 0.10, p < 0.01) and tricuspid (,0.09 ± 0.07, p < 0.01) valves, indicating reduced early diastolic ventricular fillings compared with donors. Conclusion:, At school age, twins surviving TTTS had a cardiac structure and function within normal range. There were no differences in heart structure or systolic ventricular function between twins but, compared with the donor twin, we found a reduced early diastolic function in the recipient. [source]