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This Article Full Text Full Text (PDF) Take the CME quiz: Vol. 9 No. 9, September 2008 E-Letters: Submit a response Alert me when this article is cited Alert me when E-Letters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Faye-Petersen, O. M. Articles by Crombleholme, T. M. PubMed Articles by Faye-Petersen, O. M. Articles by Crombleholme, T. M.

NeoReviews Vol.9 No.9 2008 e380
© 2008 American Academy of Pediatrics

Twin-to-Twin Transfusion Syndrome

Part 2. Infant Anomalies, Clinical Interventions, and Placental Examination

Ona M. Faye-Petersen, MD^*
Timothy M. Crombleholme, MD

^* Associate Professor of Pathology and Obstetrics and Gynecology; Head, Microdissection Laboratory, Division of Anatomic Pathology, The University of Alabama at Birmingham, Birmingham, Ala
Director, Fetal Care Center of Cincinnati; Professor of Surgery, Pediatrics, and Obstetrics and Gynecology, University of Cincinnati College of Medicine; Division of Pediatric General, Thoracic, and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

Most anomalies seen in fetuses and neonates who have chronic twin-to-twin transfusion syndrome (TTTS) represent sequelae of cardiovascular dysfunction or vascular disruption. The placental examination can provide critical information to the neonatologist caring for infants who have a history of TTTS, especially in instances wherein the twins are not necessarily growth-discordant but have cardiovascular or renal dysfunction or neuropathologic findings. In this review, we present an updated discussion of the fetal and neonatal pathologies and adverse sequelae associated with TTTS and advances in antenatal diagnosis and clinical interventions for monochorionic gestations complicated by TTTS. We also present highlights of the placental examination so the neonatologist can inspect the placenta at the time of delivery and possibly gain insights that may affect patient care.