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Twin-to-Twin Transfusion Syndrome Daniel W Skupski

SECTION 1: WHERE DID WE COME FROM?
CHAPTER 1:History
- INTRODUCTION
- DISTANT HISTORY
- FETAL DIAGNOSIS AND THERAPY
  - Laser Therapy
- COLLABORATION
- SUMMARY
SECTION 2: WHY DOES TTTS OCCUR?
CHAPTER 2:The Hidden Costs of Monochorionicity
- INTRODUCTION
- THE MAGNITUDE OF THE PROBLEM
- APPARENT AND HIDDEN COSTS OF MONOCHORIONIC TWINS
CHAPTER 3:Placentation
- INTRODUCTION
- PLACENTAL ANATOMY
  - Early Placental Development
  - Chorionic Plate Architecture
- A HYPOTHESIS REGARDING ZYGOSITY, CHORIONICITY, THE INTER-TWIN MEMBRANE AND VASCULAR CONNECTIONS
  - Vascular Connections Throughout Gestation
- SUMMARY
CHAPTER 4:Pathophysiology
- INTRODUCTION
- PLACENTAL PATHOPHYSIOLOGY
- FETAL PATHOPHYSIOLOGY
- CONCLUSION
- ACKNOWLEDGMENT
CHAPTER 5:Color Injection and Digital Angiography
- INTRODUCTION
- EXPLAINING CLINICAL SYMPTOMS OF MONOCHORIONIC TWINS THROUGH POSTNATAL CORRELATION WITH THE PLACENTA
- CORRELATING PRENATAL SONOGRAPHIC AND INTRAUTERINE LASER FINDINGS OF MONOCHORIONIC TWINS WITH THE PLACENTAL VASCULATURE BY COLOR INJECTIONS
- CONCLUSION
SECTION 3: WHAT IS TTTS?
CHAPTER 6:Natural History
- INTRODUCTION
- MISSTEPS
- DETERMINING THE NATURAL HISTORY OF TWIN-TO-TWIN TRANSFUSION SYNDROME
- SUMMARY
CHAPTER 7:Clinical Effects
- INTRODUCTION
- THE MONOCHORIONIC PLACENTA
- CLINICAL EVOLUTION AND IMPLICATIONS FOR SURVEILLANCE AND RISK ASSESSMENT
- CONCLUSION
CHAPTER 8:Diagnosis
- INTRODUCTION
- DIAGNOSIS OF CHORIONICITY
- ULTRASOUND SURVEILLANCE OF THE MONOCHORIONIC TWIN GESTATION
- DIAGNOSIS OF TWIN-TO-TWIN TRANSFUSION SYNDROME
- CONCLUSION
CHAPTER 9:Maternal Nutrition
- INTRODUCTION
- METHODS
- RESULTS
- CONSEQUENCES
CHAPTER 10:The Cervix
- RISK OF SPONTANEOUS PRETERM BIRTH IN TWINS
  - Cervical Length and the Risk of Preterm Birth
- INTERVENTIONS TO PREVENT PRETERM BIRTH IN THE SETTING OF A SHORT CERVIX
  - Interventions for Short Cervix in the Setting of TTTS
  - Pessary
- SUMMARY
SECTION 4: WHEN DOES TTTS OCCUR?
CHAPTER 11:Acute Twin-to-Twin Transfusion Syndrome
- INTRODUCTION
- ETIOLOGY
- INCIDENCE
- LITERATURE REVIEW
- HYPOTHESES
- MANAGEMENT
- SUMMARY
CHAPTER 12:Triplets
- INTRODUCTION
- PREVALENCE OF FETO-FETAL TRANSFUSION SYNDROME (FFTS) IN TRIPLETS
  - FFTS in Dichorionic vs Monochorionic Triplets
- OUTCOMES WITH NO TREATMENT
- TREATMENT OPTIONS
- NEONATAL FOLLOW-UP
- COUNSELING AND ETHICAL CONSIDERATIONS
- UNANSWERED QUESTIONS
- CONCLUSION
SECTION 5: HOW DO WE TREAT TTTS?
CHAPTER 13:Therapy
- TREATMENT OPTIONS
- ANESTHESIA
- ABDOMINAL ENTRY
- TECHNIQUE
- OPERATIVE TIME
- LEARNING CURVE
- PERIOPERATIVE CARE AND FOLLOW-UP
- SURGICAL FAILURE
- COMPLICATIONS
- CONCLUSION
CHAPTER 14:Neonatal Outcomes
- INTRODUCTION
- NEONATAL MORTALITY
- NEONATAL MORBIDITY
- CONCLUSION
CHAPTER 15:Monitoring of Disease
- INTRODUCTION
- MONITORING STAGE I TTTS
  - Monitoring TTTS Pregnancies Following Laser Surgery
  - Monitoring Fetal Condition after Laser
- COMPLICATIONS: WHAT TO LOOK FOR (BOX 15.2)
- SINGLE FETAL DEATH: WHAT TO DO?
- CONCLUSION
CHAPTER 16:Ethical Dimensions
- INTRODUCTION
- THE ETHICS OF NON-DIRECTIVE AND DIRECTIVE COUNSELING IN THE INFORMED CONSENT PROCESS
  - Ethically Justified Decision-Making Pathway
- CONCLUSION
SECTION 6: WHAT'S NEXT?
CHAPTER 17:The Future

INDEX

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Chapter Notes