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- W2066183713 abstract "A case of MCMA twins discordant for growth and for complex major cardiac malformation was diagnosed at 18 weeks' gestation. The smaller twin showed critically abnormal Doppler studies in the umbilical artery and in the ductus venosus. A complete echocardiography revealed a major heart malformation: double-outlet right ventricle, abnormal pulmonary venous return to the right atria, pulmonary stenosis and a ventricular septal defect, in the setting of situs inversus with the stomach and descending aorta located in the right side while the liver and inferior vena cava in the left side of the column, respectively. A likely right isomerism was diagnosed. These findings were confirmed in the follow-up ultrasound performed two weeks later. In view of the high risk of spontaneous death of the malformed fetus, parents were extensively counseled and opted for selective feticide. The procedure was performed at 21 + 1 weeks' gestation under local anesthesia. Both umbilical cords were closely inserted in a posterior placenta and cord entanglement could be easily visualized. The selective feticide of the abnormal fetus was successfully performed by ultrasound guide bipolar coagulation and fetoscopically guide laser transection of the umbilical cord. The pregnancy continued uneventfully and a normal 2720 g female infant was born at 37 weeks' gestation after spontaneous vaginal delivery, with Apgar score of 10 at 5 minutes. The terminated twin was quite well-preserved, so pathological examination confirmed all the prenatal findings. At 6 months of age, the baby is developing normally with no neurological abnormalities. Selective feticide in complicated monoamniotic pregnancies can be safely performed. The presence of cord entanglement makes the transection of the cord mandatory." @default.
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- W2066183713 date "2007-09-21" @default.
- W2066183713 modified "2023-09-27" @default.
- W2066183713 title "P51.14: Coagulation and section of the umbilical cord in a 21 weeks' gestation monochorionic monoamniotic twins discordant for cardiosplenic syndrome" @default.
- W2066183713 doi "https://doi.org/10.1002/uog.5077" @default.
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