First trimester twin-to-twin transfusion syndrome in a trichorionic quadruplet pregnancy - A diagnostic challenge

Cristoph Berg, A. A. Baschat, A. Geipel, U. Germer, J. Smrcek, M. Krapp, U. Gembruch

Research output: Contribution to journalArticlepeer-review

Abstract

We report the prenatal diagnosis of twin-to-twin transfusion syndrome (TTS) at 11 weeks' gestation. The diagnosis was made in a trichorionic quadruplet pregnancy which was conceived after in vitro fertilization and intra-cytoplasmic sperm injection for male subfertility and transfer of 3 embryos. Growth discordance, oligo/polyhydramnios and abnormal arterial and venous Doppler flows were demonstrated in 2 monochorionic fetuses, while the remaining 2 dichorionic fetuses were unremarkable. Selective fetocide of the donor by intracardiac injection of potassium chloride was followed by the spontaneous demise of the recipient. The pregnancy course remained uneventful until 32 weeks of gestation when the patient developed preterm labor. Two healthy preterm babies were delivered by cesarean section. The diagnostic problems of this early manifestation of TTS are discussed.

Original languageEnglish (US)
Pages (from-to)357-361
Number of pages5
JournalFetal Diagnosis and Therapy
Volume17
Issue number6
DOIs
StatePublished - Dec 1 2002
Externally publishedYes

Keywords

  • Assisted reproduction
  • First trimester
  • Quadruplet pregnancy
  • Twin-to-twin transfusion syndrome
  • Ultrasound

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Embryology
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynecology

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