Midtrimester genetic amniocentesis of a twin gestation complicated by immediate severe fetal bradycardia with subsequent associated fetal anomalies.

Abstract:

:We present an unusual complication of midtrimester genetic amniocentesis of a monochorionic twin gestation in which prolonged fetal bradycardia of 60 to 80 beats per minute sustained over two hours was associated with multiple subsequent fetal anomalies. These included: microcephaly, bilateral closed-lip schizencephaly, duodenal atresia, and complete paresis of the left upper extremity. Etiology of the fetal bradycardia was unclear. Fetal hemorrhage was not visualized despite targeted, continued real-time ultrasonography and was therefore considered an unlikely etiology. Although the bradycardia and associated hypoperfusion could alone explain the fetal outcome, destabilization of hemodynamics of a communicating vessel, resulting in a possible (although unproven) acute twin-twin transfusion induced at the time of amniocentesis due to decreased intra-amniotic pressure in association with a velamentous umbilical cord insertion could have led to this unusual occurrence.

journal_name

Am J Perinatol

authors

Sherer DM,Salafia CM

doi

10.1055/s-2007-994354

subject

Has Abstract

pub_date

1996-08-01 00:00:00

pages

347-50

issue

6

eissn

0735-1631

issn

1098-8785

journal_volume

13

pub_type

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