This expert panel webinar, hosted by Prof. Asma Khalil, explores complex fetal intervention cases in twin and multiple pregnancies, with contributions from leading clinicians across the UK, USA, India, and advocacy groups.
The session opens with an overview of the unique pathophysiology in monochorionic twins, including shared placental vascular connections that lead to complications such as Twin-to-Twin Transfusion Syndrome (TTTS), Twin Anemia-Polycythemia Sequence (TAPS), and Selective Fetal Growth Restriction (sFGR). Diagnostic frameworks and ultrasound findings are explained, including abnormal Doppler waveforms, amniotic fluid imbalances, and intertwin hemoglobin discrepancies.
A rare case of monochorionic triplets with a conjoined pair is reviewed, detailing how fetoscopic cord ligation and laser transection were used to manage the case due to the size and complexity of the shared cord. Counseling challenges in such undocumented scenarios are addressed, alongside procedural considerations to minimize risks such as reverse perfusion and cord entanglement.
Additional case studies include unusual twin pregnancies requiring selective fetal reduction, interventions for severe discordant anomalies, and management of structural complications like a short cervix. The discussion integrates procedural planning, risk assessment, and the role of shared decision-making in cases where clinical evidence is limited.
Throughout, the webinar emphasizes the role of fetal intervention in improving outcomes for twin pregnancy complications, grounded in thorough ultrasound assessment, individualized treatment plans, and multidisciplinary coordination.
To continue exploring complex case studies, watch Part 2 of the fetal interventions in twin and multiple pregnancy series.
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