Article
Pediatrics
Angel Chimenea, Lutgardo Garcia-Diaz, Guillermo Antinolo
Summary: This study aimed to evaluate the risk of neurodevelopmental impairment in monochorionic diamniotic twins undergoing fetoscopic laser surgery for twin-twin transfusion syndrome (TTTS) compared to uncomplicated MCDA twin pregnancies. The results showed that the outcome in MCDA twins who underwent surgery for TTTS was comparable to uncomplicated MCDA twins. These findings underscore the importance of long-term neurodevelopmental follow-up in children from monochorionic twin pregnancies.
Article
Biotechnology & Applied Microbiology
Tianjiao Liu, Li Wen, Shuai Huang, Ting-Li Han, Lan Zhang, Huijia Fu, Junnan Li, Chao Tong, Hongbo Qi, Richard Saffery, Philip N. Baker, Mark D. Kilby
Summary: This study investigated the metabolic changes caused by twin-twin transfusion syndrome and the effects of fetoscopic laser coagulation on placental tissue and cord plasma metabolism. The results showed that cord plasma metabolome performed better in differentiating fetuses with varying hemodynamic statuses. Fetoscopic laser coagulation improved the metabolomic alterations and identified potential biomarkers related to neonatal birth weight and cardiac function.
FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY
(2022)
Article
Obstetrics & Gynecology
Angela Guzys, Susan M. Reid, Christie Bolch, Dinah S. Reddihough, Mark Teoh, Ricardo Palma-Dias, Alison Fung, Stephen Cole, Ryan Hodges, Michael Fahey, Susan P. Walker
Summary: This study aimed to investigate the presence of neurodevelopmental disabilities in child survivors of monochorionic pregnancies managed by placental laser photocoagulation in Victoria, Australia. The study found that approximately 31% of the survivors had neurodevelopmental impairment, with speech/language disorders, attention deficit (hyperactivity) disorders, and fine motor impairment being the most common. Neonatal length of stay was identified as the highest risk factor for impairment.
BMC PREGNANCY AND CHILDBIRTH
(2023)
Article
Acoustics
R. Donepudi, J. Espinoza, A. A. Nassr, M. A. Belfort, A. A. Shamshirsaz, M. Sanz Cortes
Summary: Selective fetal growth restriction (sFGR) complicating twin-twin transfusion syndrome (TTTS) is associated with an increased risk of fetal demise after fetoscopic laser surgery (FLS). The Delphi method of defining sFGR based on the presence of at least two of four contributory criteria had the highest predictive value for donor demise following FLS for TTTS.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2021)
Article
Obstetrics & Gynecology
Ryo Yamamoto, Kentaro Nakanishi, Haruna Kawaguchi, Shusaku Hayashi, Keisuke Ishii
Summary: The study found that the prevalence of extraplacental anastomoses (EPA) in monochorionic diamniotic (MCDA) twin pregnancies is approximately 5%, with a significant association with velamentous cord insertion of both twins.
FETAL DIAGNOSIS AND THERAPY
(2021)
Article
Genetics & Heredity
Anna M. Armitage, Monica A. Kundra, Neda Ghiam, Paldeep S. Atwal, Dayna Morel, Kathleen S. Hruska, Rebecca Torene, Irman Forghani
Summary: This case report describes the first instance of blood chimerism involving a pathogenic RB1 variant in naturally conceived monochorionic-dizygotic twins with twin-twin-transfusion syndrome, likely due to stem cell exchange. The affected twin developed bilateral retinoblastoma at 7 months of age, with both twins having a 20% allelic ratio of the RB1 pathogenic variant in their blood. Subsequent genotyping confirmed dizygosity, with the affected twin harboring the variant in skin and blood, while the unaffected twin only had the variant in blood.
AMERICAN JOURNAL OF MEDICAL GENETICS PART A
(2021)
Article
Obstetrics & Gynecology
Vatsla Dadhwal, K. Aparna Sharma, Anubhuti Rana, Akash Sharma, Lakhwinder Singh
Summary: This study demonstrates that selective fetal reduction using radiofrequency ablation is safe and effective in complicated monochorionic twin pregnancies. However, rates of preterm prelabor rupture of membranes and preterm delivery remain high.
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS
(2022)
Review
Obstetrics & Gynecology
Liesbeth Lewi
Summary: About 1 in 5 twin pregnancies are monochorionic diamniotic, which can lead to transfusion imbalances and other complications. Fetoscopic laser coagulation is used to address these imbalances. In addition, structural anomalies are more common in monochorionic twins while chromosomal anomalies are less common.
AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM
(2022)
Article
Obstetrics & Gynecology
Inmaculada Duyos, Polan Ordas, Beatriz Herrero, Roberto Rodriguez, Miguel Jesus Cabrero, Amelia Fernandez-Zubillaga, Jesus Benito Diez Sebastian, Maria De La Calle, Jose Luis Bartha, Eugenia Antolin
Summary: This study aimed to evaluate the perinatal outcome of monochorionic twins with single intrauterine fetal death, both spontaneous and after fetal therapy, and to assess the antenatal events that increase the risk of cerebral injury. The study found that the risk of cerebral damage is higher in cases of spontaneous intrauterine fetal death, and gestational age at death, selective intrauterine growth restriction, and anemia of the surviving co-twin are the main predictors for prenatal lesions. The overall perinatal survival rate was 88.3% and abnormal neurological outcomes were related to extreme prematurity.
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
(2023)
Article
Medicine, General & Internal
Izabela Walasik, Magdalena Litwinska, Katarzyna Janiak, Krzysztof Szaflik, Piotr Kaczmarek, Artur Ludwin, Ewelina Litwinska
Summary: This study compared the short- and long-term outcomes of monochorionic twin pregnancies with the Twin Reversed Arterial Perfusion Sequence (TRAP) using two different techniques: interstitial fetal laser (IFL) and endoscopic cord occlusion (CO). The study found that IFL was associated with a higher risk of early pregnancy loss, but lower risks of preterm birth and neurological disabilities in survivors, while CO showed the opposite results.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Obstetrics & Gynecology
Manasa G. Rao, Luciana Vieira, Elianna Kaplowitz, Jessica R. Overbey, Shaelyn Johnson, Keisha Paul, Robert Lookstein, Andrei Rebarber, Nathan S. Fox, Joanne Stone
Summary: In patients with monochorionic diamniotic twins, elective multifetal pregnancy reduction via radiofrequency ablation led to significantly lower rates of preterm birth at <37 weeks and a lower trend of pre term birth at <36 weeks' gestation without an increased risk of pregnancy loss. The median gestational age at delivery was significantly higher in the elective multifetal pregnancy reduction group (38 weeks) than in the ongoing pregnancy group (35.9 weeks). Further research is needed to clarify if multifetal pregnancy reduction improves long-term outcomes.
AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM
(2021)
Article
Developmental Biology
Lubomir Haslik, Jiri Vojtech, Petra Hanulikova, Petr Krepelka, Jaroslav Feyereisl, Ladislav Krofta
Summary: The study revealed that single intrauterine fetal death may lead to acute feto-fetal transfusion in monochorionic twins, mainly influenced by arterio-arterial anastomoses. The diameter and length of AA anastomoses play a crucial role in transfusion risk, which is related to the distance of umbilical cords insertions.
Article
Medicine, General & Internal
Mingming Tang, Xingbo Tian, Jianglai Luo, Xiaohang Zhang, Suzhen Ran, Jiaojiao Xiong, Yanlin Chen, Gongli Chen
Summary: This article reports an extremely rare case of dizygotic monochorionic triamniotic triplet pregnancy, in which twin-twin transfusion syndrome was subsequently diagnosed with sex discordance in the two surviving fetuses after one fetus was reduced.
FRONTIERS IN MEDICINE
(2022)
Article
Medicine, General & Internal
Yao-Lung Chang, Chin-Chieh Hsu, An-Shine Chao, Shuenn-Dyh Chang, Po-Jen Cheng, Wen-Fang Li
Summary: This study investigates the fetal growth pattern after fetoscopic laser photocoagulation (FLP) in twin-twin transfusion syndrome (TTTS) and the effect of FLP on placental perfusion and intrauterine growth restriction (IUGR) incidence. The results suggest that FLP can decrease body weight discordance (BWD), improve the prognosis of TTTS, and reduce the incidence of IUGR in donor twins.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Obstetrics & Gynecology
Juliana Gebb, Rosa Hwang, Christina Paidas Teefey, Shelly Soni, Beverly G. Coleman, Deborah M. Zarnow, Julie S. Moldenhauer, Nahla Khalek
Summary: Neurologic injury in the surviving twin is a risk after single fetal demise in a monochorionic pregnancy. This study aimed to describe fetal magnetic resonance neuroimaging findings in pregnancies complicated by single fetal demise after laser photocoagulation for twin-twin transfusion syndrome.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2022)
Article
Genetics & Heredity
Aymara Taillieu, Jan Deprest, Simen Vergote, Anne Debeer, Francesca Maria Russo, Beverley Power, Frank Meijer, Neeltje Crombag
Summary: This study aimed to identify patient-reported outcomes for parents with a prenatal diagnosis of isolated congenital diaphragmatic hernia (CDH). Thematic analysis of in-depth interviews identified 11 key outcomes throughout the CDH trajectory, including survival chances, maternal complications, and family impact. These outcomes provide important directions for clinicians to support parents and their family in making challenging healthcare decisions.
PRENATAL DIAGNOSIS
(2023)
Article
Genetics & Heredity
Yada Kunpalin, Simen Vergote, Luc Joyeux, Onur Telli, Anna L. David, Michael Belfort, Paolo De Coppi, Jan Deprest
Summary: A study on commercially available patches used in fetal rabbit models for spina bifida repair found that covering the spinal cord with Duragen or Durepair and closing the skin preserves motor neuron density and reduces the inflammatory response.
PRENATAL DIAGNOSIS
(2023)
Article
Chemistry, Multidisciplinary
Andrea Urru, Ayako Nakaki, Oualid Benkarim, Francesca Crovetto, Laura Segales, Valentin Comte, Nadine Hahner, Elisenda Eixarch, Eduard Gratacos, Fatima Crispi, Gemma Piella, Miguel A. Gonzalez Ballester
Summary: In this study, a new pipeline for fetal and neonatal segmentation has been developed, along with the creation of two new fetal atlases. The results show that the use of the new templates and segmentation strategy leads to accurate results, outperforming a reference pipeline in early and late-onset fetal brain segmentation.
Review
Acoustics
B. Packet, A. -s. Page, L. Cattani, J. Bosteels, J. Deprest, J. Richter
Summary: This systematic review investigates predictive factors for obstetric anal sphincter injury (OASI) occurrence at first vaginal delivery using ultrasound diagnosis. The study found that increasing gestational age at delivery, shorter antepartum perineal body length, labor augmentation, instrumental delivery, shoulder dystocia, episiotomy use, and shorter episiotomy length were associated with ultrasound-diagnosed OASI.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2023)
Article
Acoustics
S. Vergote, J. van der Stock, Y. Kunpalin, E. Bredaki, H. Maes, S. Banh, L. De Catte, R. Devlieger, L. Lewi, S. Devroe, R. Spencer, A. David, P. De Vloo, F. Van Calenbergh, J. A. Deprest
Summary: This prospective single-center audit examined the fetal and maternal adverse events following fetal surgery for spina bifida and assessed the impact of patient engagement in collecting follow-up data. The study found that severe complications could occur in both the fetus and the mother after the surgery, but the nature and rate of these complications were similar to those reported in other studies. Patient empowerment and involvement improved the collection of outcome data.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2023)
Article
Obstetrics & Gynecology
Lucas Trigo, Elisenda Eixarch, Fernanda Faig-Leite, Marta Gomez-Chiari, Monica Rebollo, Mariana Dalaqua, Eduard Gratacos, Denise Lapa
Summary: This study investigated the changes in central nervous system anomalies before and after prenatal open spina bifida repair and their relationship with postnatal neurologic outcomes. The results showed a reduction in hindbrain herniation and a normalization of the clivus supraocciput angle after surgery, but no significant increase in abnormal corpus callosum or heterotopia. However, the presence of abnormal corpus callosum and severe ventriculomegaly was associated with an increased risk of suboptimal neurodevelopment.
AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM
(2023)
Article
Developmental Biology
M. Aertsen, A. Melbourne, I. Couck, E. King, S. Ourselin, F. De Keyzer, S. Dymarkowski, J. Deprest, L. Lewi
Summary: This study investigates diffusion and relaxation differences in uncomplicated MCDA pregnancies and MCDA pregnancies complicated by TTTS and sFGR in mid-pregnancy. The results show significant differences in several MRI parameters between the placenta of uncomplicated MCDA pregnancies and those complicated by sFGR and TTTS.
Article
Genetics & Heredity
Simen Vergote, Francesca Maria Russo, David Basurto, Jan Deprest, Neeltje Crombag
Summary: The survey shows that most maternal-fetal medicine specialists consider the risk-benefit ratio of FETO for severe LCDH and RCDH clear and often offer this treatment option. However, they are uncertain about the risks and benefits of FETO for moderate LCDH and severe RCDH, and therefore do not frequently offer this option. However, not offering FETO to parents is considered a psychological burden.
PRENATAL DIAGNOSIS
(2023)
Article
Obstetrics & Gynecology
Han-Shin Lee, Nimrah Abbasi, Tim Van Mieghem, Elad Mei-Dan, Francois Audibert, Richard Brown, Sarah Coad, Liesbeth Lewi, Jon Barrett, Greg Ryan
JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA
(2023)
Article
Obstetrics & Gynecology
Han -Shin Lee, Nimrah Abbasi, Tim Van Mieghem, Elad Mei-Dan, Francois Audibert, Richard Brown, Sarah Coad, Liesbeth Lewi, Jon Barrett, Greg Ryan
Summary: This guideline provides evidence-based management recommendations for both normal and complicated monochorionic twin pregnancies. Implementing these recommendations can improve the monitoring and management of both uncomplicated and complicated monochorionic twin pregnancies, which reduces perinatal morbidity and mortality. The guideline also highlights the importance of more frequent ultrasound monitoring for monochorionic twins compared to dichorionic twins.
JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA
(2023)
Meeting Abstract
Obstetrics & Gynecology
Sofia Mastrodima-Polychroniou, Serena Banh, Adalina Sacco, Emma Bredaki, Georgina Murray, Michael Aertsen, Frank Van Calenbergh, Philippe Devloo, Roland Devlieger, Liesbeth Lewi, Luc De Catte, Kelly Pegoretti Baruteau, Trevor Gaunt, George Attilakos, Ruwan Wimalasundera, Zubair Tahir, Dominic Thompson, Paolo De Coppi, Anna David, Jan Deprest
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
(2023)
Meeting Abstract
Obstetrics & Gynecology
Kobe Haenen, Simen Vergote, Yada Kunpalin, Luc De Catte, Roland Devlieger, Liesbeth Lewi, Hannes van der Merwe, Francesca Russo, Philippe De Vloo, Jan Deprest
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
(2023)
Article
Engineering, Biomedical
Viktor Voros, Jef De Smet, Mouloud Ourak, Vladimir Poliakov, Jan Deprest, Tom Kimpe, Emmanuel Vander Poorten
Summary: This study investigates the use and benefits of an autostereoscopic (3D) display in a simulated laparoscopic task, aiming to restore the sense of depth. Results show that 3D vision improves task completion time, total traveled distance, and error rate compared to 2D visualization.
INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY
(2023)
Article
Obstetrics & Gynecology
Nada Mufti, Michael Aertsen, Dominic Thomson, Phillippe De Vloo, Philippe Demaerel, Jan Deprest, Andrew Melbourne, Anna L. David
Summary: This study investigated the use of fetal magnetic resonance imaging (MRI) for open spina bifida (OSB) patients eligible for fetal surgery. The results showed that there was timely access to supervised MRI, but the acquisition of important imaging parameters was not widespread. Specific guidance for fetal MRI for OSB is suggested.
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
(2023)
Review
Genetics & Heredity
Yair J. Blumenfeld, Kunj R. Sheth, Eric Johnson, James K. Wall, Jan A. Deprest, Francesca M. Russo, Enrico Danzer
Summary: Fetal lower urinary tract obstruction (LUTO) is a severe malformation that can lead to high mortality and morbidity. Fetal vesico-amniotic shunts (VAS) have been used to bypass the obstruction, but currently available shunts have high dislodgement rates. We have developed a novel Vortex shunt that aims to improve deployment accuracy and reduce dislodgement risk.
PRENATAL DIAGNOSIS
(2023)
