Early second trimester twin embolization syndrome

Uriel Elchalal, Vasilios Tanos, Benjamin Bar-Oz, Michael Nadjari

Research output: Contribution to journalArticlepeer-review

Abstract

Twin embolization syndrome is a rare complication of monochorionic twin gestation after the fetal death of one of the monozygotic twins and is related to the vascular connections in monochorionic placentas. The cause is thought to be placental transfer of emboli or thromboplastic material through vascular shunts. These thromboplastic agents precipitate disseminated intravascular coagulation in the surviving fetus, with a hypercoagulable state due to a relative fetal antithrombin III deficiency. Serial sonographic examinations can identify twin embolization syndrome Prenatally. Theoretically, premature delivery and treatment of a fetus at an early stage may reduce the degree of cerebral as well as other organ damage. The benefits of this theoretical approach must be balanced by the inevitable risks of prematurity, complications of anticoagulant therapy, and risks after treatment such as fetoscopic laser vessel occlusion. We present a case of the early fetal death of one twin at 14 gestational weeks that caused twin embolization syndrome in the surviving twin.

Original languageEnglish
Pages (from-to)509-512
Number of pages4
JournalJournal of Ultrasound in Medicine
Volume16
Issue number7
Publication statusPublished - 1997

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