The role of veno-venous anastomoses in twin-twin transfusion syndrome

D P Zhao; D Cohen; J M Middeldorp; F J Klumper; M C Haak; D Oepkes; E Lopriore

doi:10.1016/j.placenta.2014.03.002

The role of veno-venous anastomoses in twin-twin transfusion syndrome

Placenta. 2014 May;35(5):334-6. doi: 10.1016/j.placenta.2014.03.002. Epub 2014 Mar 14.

Authors

D P Zhao¹, D Cohen², J M Middeldorp³, F J Klumper³, M C Haak³, D Oepkes³, E Lopriore⁴

Affiliations

¹ Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, J6-S, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. Electronic address: [email protected].
² Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
³ Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
⁴ Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, J6-S, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. Electronic address: [email protected].

PMID: 24680292
DOI: 10.1016/j.placenta.2014.03.002

Abstract

The aim of this study was to investigate the independent role of veno-venous (VV) anastomoses in the development of twin-twin transfusion syndrome (TTTS). Thirty TTTS placentas and 41 non-TTTS placentas, routinely injected with colored dye, were enrolled in this study. We excluded all cases with arterio-arterial (AA) anastomoses and TTTS cases treated with laser surgery. The prevalence of VV anastomoses was significantly higher in TTTS cases compared to non-TTTS cases, 37% (11/30) and 7% (3/41), respectively (P < .01; odds ratio 7.3; 95% confidence interval: 1.8-37.1). Our findings suggest that, in the absence of AA anastomoses, VV anastomoses may enhance the development of TTTS.

Keywords: Monochorionic twins; Twin–twin transfusion syndrome; Veno-venous anastomosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Female
Fetofetal Transfusion / pathology*
Humans
Microvessels / pathology*
Placenta / pathology*
Pregnancy
Veins / pathology*