Discordant placental echogenicity: A novel sign of impaired placental perfusion in twin-twin transfusion syndrome?

Juan Pedro Kusanovic; Roberto Romero; Francesca Gotsch; Pooja Mittal; Offer Erez; Chong Jai Kim; Sonia S. Hassan; Jimmy Espinoza; Lami Yeo

doi:10.3109/14767050903005873

Discordant placental echogenicity: A novel sign of impaired placental perfusion in twin-twin transfusion syndrome?

Juan Pedro Kusanovic, Roberto Romero, Francesca Gotsch, Pooja Mittal, Offer Erez, Chong Jai Kim, Sonia S. Hassan, Jimmy Espinoza, Lami Yeo

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

Abstract

Twin-twin transfusion syndrome (TTTS) is present in approximately 5-15% of monochorionic-diamniotic twin pregnancies. A chronic blood flow imbalance through placental vascular anastomoses from the donor to the recipient twin is considered the pathophysiologic mechanism responsible for the development of TTTS. Discordant echogenicity between the donor and recipient placenta has been proposed in a previous case report as an additional sonographic sign of TTTS. Here, we present a case of TTTS with discordant placental echogenicity characterized by a hyperechoic and thicker placental side in the donor twin associated with reduced vascular Doppler signals, histologic lesions suggestive of ischemic changes, and overexpression of anti-angiogenic factors.

Original language	English
Pages (from-to)	103-106
Number of pages	4
Journal	Journal of Maternal-Fetal and Neonatal Medicine
Volume	23
Issue number	1
DOIs	https://doi.org/10.3109/14767050903005873
State	Published - 1 Jan 2010
Externally published	Yes

Keywords

Angiogenesis
Anti-angiogenic state
Endoglin
Monochorionic
Placenta
Placental growth factor
TTTS
VEGFR-1

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynecology

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title = "Discordant placental echogenicity: A novel sign of impaired placental perfusion in twin-twin transfusion syndrome?",

abstract = "Twin-twin transfusion syndrome (TTTS) is present in approximately 5-15% of monochorionic-diamniotic twin pregnancies. A chronic blood flow imbalance through placental vascular anastomoses from the donor to the recipient twin is considered the pathophysiologic mechanism responsible for the development of TTTS. Discordant echogenicity between the donor and recipient placenta has been proposed in a previous case report as an additional sonographic sign of TTTS. Here, we present a case of TTTS with discordant placental echogenicity characterized by a hyperechoic and thicker placental side in the donor twin associated with reduced vascular Doppler signals, histologic lesions suggestive of ischemic changes, and overexpression of anti-angiogenic factors.",

keywords = "Angiogenesis, Anti-angiogenic state, Endoglin, Monochorionic, Placenta, Placental growth factor, TTTS, VEGFR-1",

author = "Kusanovic, {Juan Pedro} and Roberto Romero and Francesca Gotsch and Pooja Mittal and Offer Erez and Kim, {Chong Jai} and Hassan, {Sonia S.} and Jimmy Espinoza and Lami Yeo",

note = "Funding Information: This research was supported by the Perinatology Research Branch, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS.",

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doi = "10.3109/14767050903005873",

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T2 - A novel sign of impaired placental perfusion in twin-twin transfusion syndrome?

AU - Kusanovic, Juan Pedro

AU - Romero, Roberto

AU - Gotsch, Francesca

AU - Mittal, Pooja

AU - Erez, Offer

AU - Kim, Chong Jai

AU - Hassan, Sonia S.

AU - Espinoza, Jimmy

AU - Yeo, Lami

N1 - Funding Information: This research was supported by the Perinatology Research Branch, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS.

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Twin-twin transfusion syndrome (TTTS) is present in approximately 5-15% of monochorionic-diamniotic twin pregnancies. A chronic blood flow imbalance through placental vascular anastomoses from the donor to the recipient twin is considered the pathophysiologic mechanism responsible for the development of TTTS. Discordant echogenicity between the donor and recipient placenta has been proposed in a previous case report as an additional sonographic sign of TTTS. Here, we present a case of TTTS with discordant placental echogenicity characterized by a hyperechoic and thicker placental side in the donor twin associated with reduced vascular Doppler signals, histologic lesions suggestive of ischemic changes, and overexpression of anti-angiogenic factors.

AB - Twin-twin transfusion syndrome (TTTS) is present in approximately 5-15% of monochorionic-diamniotic twin pregnancies. A chronic blood flow imbalance through placental vascular anastomoses from the donor to the recipient twin is considered the pathophysiologic mechanism responsible for the development of TTTS. Discordant echogenicity between the donor and recipient placenta has been proposed in a previous case report as an additional sonographic sign of TTTS. Here, we present a case of TTTS with discordant placental echogenicity characterized by a hyperechoic and thicker placental side in the donor twin associated with reduced vascular Doppler signals, histologic lesions suggestive of ischemic changes, and overexpression of anti-angiogenic factors.

KW - Angiogenesis

KW - Anti-angiogenic state

KW - Endoglin

KW - Monochorionic

KW - Placenta

KW - Placental growth factor

KW - TTTS

KW - VEGFR-1

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U2 - 10.3109/14767050903005873

DO - 10.3109/14767050903005873

M3 - Article

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SN - 1476-7058

VL - 23

SP - 103

EP - 106

JO - Journal of Maternal-Fetal and Neonatal Medicine

JF - Journal of Maternal-Fetal and Neonatal Medicine

IS - 1

ER -

Discordant placental echogenicity: A novel sign of impaired placental perfusion in twin-twin transfusion syndrome?

Abstract

Keywords

ASJC Scopus subject areas

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