Identification of arterio–venous anastomoses in vivo in monochorionic twin pregnancies: preliminary report

Objective To determine whether it is possible to identify in vivo placental arterio–venous anastomoses (AVAs) by color Doppler flow mapping. Methods Three monochorionic twin pregnancies (one with and two without twin‐to‐twin transfusion syndrome) underwent placental mapping by color Doppler ultrasou...

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Published in:Ultrasound in obstetrics & gynecology 2000-09, Vol.16 (3), p.218-222
Main Authors: Taylor, M. J. O., Farquharson, D., Cox, P. M., Fisk, N. M.
Format: Article
Language:English
Subjects:
Arteriovenous Anastomosis - diagnostic imaging
Arterio–venous anastomoses
Biological and medical sciences
Chorion - diagnostic imaging
Doppler
Female
Gynecology. Andrology. Obstetrics
Humans
Management. Prenatal diagnosis
Medical sciences
Monochorionic twins
Pregnancy
Pregnancy. Fetus. Placenta
Twins, Monozygotic
Twin‐to‐twin transfusion
Ultrasonography, Doppler, Color
Ultrasonography, Prenatal
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Summary:Objective To determine whether it is possible to identify in vivo placental arterio–venous anastomoses (AVAs) by color Doppler flow mapping. Methods Three monochorionic twin pregnancies (one with and two without twin‐to‐twin transfusion syndrome) underwent placental mapping by color Doppler ultrasound. Placental vessels along the chorionic plate were recorded together with the direction of blood flow and their location in relation to the cord insertions and to superficial arterio–arterial anastomoses. Suggestive AVAs were mapped topographically and results were compared with the findings of formal postnatal placental injection studies. Results An AVA was identified in each of the three cases. Injection studies showed multiple AVAs. Each antenatally identified AVA was confirmed at placental injection study. Their placental location correlated to other landmarks as predicted by ultrasound. Conclusions This preliminary report demonstrates that AVAs can be identified using color Doppler ultrasound. This may facilitate planning for highly selective ablation of AVAs, and shorter procedure times. Formal studies are now indicated to determine the accuracy of this technique. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
ISSN:0960-7692
1469-0705
DOI:10.1046/j.1469-0705.2000.00227.x