Isolated ascites in a monochorionic twin after fetoscopic laser ablation is not necessarily secondary to recurrence or anaemia: bowel complications in twin-to-twin transfusion syndrome after fetoscopic laser ablation

Research output: Contribution to journalReview articlepeer-review

Standard

Harvard

APA

Vancouver

Author

Bibtex

@article{eb19e4ed50244fd395cbd86bf8dbb6f5,
title = "Isolated ascites in a monochorionic twin after fetoscopic laser ablation is not necessarily secondary to recurrence or anaemia: bowel complications in twin-to-twin transfusion syndrome after fetoscopic laser ablation",
abstract = "Background/Purpose: We report a case study of jejunal atresia and the results of a systematic literature review of all reported cases of bowel complications occurring after fetoscopic laser ablation (FLA) for the treatment of twin-to-twin transfusion syndrome (TTTS). Methods: A systematic literature review was performed of bowel complications after FLA for TTTS according to PRISMA guidelines. Results: There are 11 published cases of small bowel atresia, 5 cases of necrotising enterocolitis (NEC), and 2 cases with foetal bowel perforations. Recipient twins were more likely to be affected by small bowel atresia (7 recipient and 4 donor cases) and NEC (3 recipient and 2 donor twins). Prenatal ultrasonographic abnormalities were demonstrated in 7 out of 9 cases with bowel atresia and in both cases of bowel perforation. The overall survival rate for neonates with bowel complications after FLA is 72%, but is much lower for co-twins at 22%. The survival rates for jejunoileal atresia and NEC are 91 and 40%, respectively. Conclusions: It is uncertain as to whether these bowel anomalies are due to bowel ischaemia associated with TTTS, the treatment with FLA, or a combination of both. Cases with prenatal abdominal ultrasonographic abnormalities after FLA should have close prenatal and postnatal assessment to detect bowel complications.",
keywords = "Twin-to-twin transfusion syndrome, Fetoscopic laser ablation, Jejunal atresia, Ileal atresia, Necrotising enterocolitis, Bowel perforation",
author = "Tan, {Lee Na} and Cheung, {Ka Wang} and I. Philip and S. Ong and Mark Kilby",
year = "2018",
month = dec,
day = "14",
doi = "10.1159/000494616",
language = "English",
volume = "45",
journal = "Fetal Diagnosis and Therapy",
issn = "1015-3837",
publisher = "Karger",
number = "1",

}

RIS

TY - JOUR

T1 - Isolated ascites in a monochorionic twin after fetoscopic laser ablation is not necessarily secondary to recurrence or anaemia

T2 - bowel complications in twin-to-twin transfusion syndrome after fetoscopic laser ablation

AU - Tan, Lee Na

AU - Cheung, Ka Wang

AU - Philip, I.

AU - Ong, S.

AU - Kilby, Mark

PY - 2018/12/14

Y1 - 2018/12/14

N2 - Background/Purpose: We report a case study of jejunal atresia and the results of a systematic literature review of all reported cases of bowel complications occurring after fetoscopic laser ablation (FLA) for the treatment of twin-to-twin transfusion syndrome (TTTS). Methods: A systematic literature review was performed of bowel complications after FLA for TTTS according to PRISMA guidelines. Results: There are 11 published cases of small bowel atresia, 5 cases of necrotising enterocolitis (NEC), and 2 cases with foetal bowel perforations. Recipient twins were more likely to be affected by small bowel atresia (7 recipient and 4 donor cases) and NEC (3 recipient and 2 donor twins). Prenatal ultrasonographic abnormalities were demonstrated in 7 out of 9 cases with bowel atresia and in both cases of bowel perforation. The overall survival rate for neonates with bowel complications after FLA is 72%, but is much lower for co-twins at 22%. The survival rates for jejunoileal atresia and NEC are 91 and 40%, respectively. Conclusions: It is uncertain as to whether these bowel anomalies are due to bowel ischaemia associated with TTTS, the treatment with FLA, or a combination of both. Cases with prenatal abdominal ultrasonographic abnormalities after FLA should have close prenatal and postnatal assessment to detect bowel complications.

AB - Background/Purpose: We report a case study of jejunal atresia and the results of a systematic literature review of all reported cases of bowel complications occurring after fetoscopic laser ablation (FLA) for the treatment of twin-to-twin transfusion syndrome (TTTS). Methods: A systematic literature review was performed of bowel complications after FLA for TTTS according to PRISMA guidelines. Results: There are 11 published cases of small bowel atresia, 5 cases of necrotising enterocolitis (NEC), and 2 cases with foetal bowel perforations. Recipient twins were more likely to be affected by small bowel atresia (7 recipient and 4 donor cases) and NEC (3 recipient and 2 donor twins). Prenatal ultrasonographic abnormalities were demonstrated in 7 out of 9 cases with bowel atresia and in both cases of bowel perforation. The overall survival rate for neonates with bowel complications after FLA is 72%, but is much lower for co-twins at 22%. The survival rates for jejunoileal atresia and NEC are 91 and 40%, respectively. Conclusions: It is uncertain as to whether these bowel anomalies are due to bowel ischaemia associated with TTTS, the treatment with FLA, or a combination of both. Cases with prenatal abdominal ultrasonographic abnormalities after FLA should have close prenatal and postnatal assessment to detect bowel complications.

KW - Twin-to-twin transfusion syndrome

KW - Fetoscopic laser ablation

KW - Jejunal atresia

KW - Ileal atresia

KW - Necrotising enterocolitis

KW - Bowel perforation

U2 - 10.1159/000494616

DO - 10.1159/000494616

M3 - Review article

VL - 45

JO - Fetal Diagnosis and Therapy

JF - Fetal Diagnosis and Therapy

SN - 1015-3837

IS - 1

ER -