St. Louis Fetal Care Institute Offers Promising Fetal Surgery for Saving Twins with Selective Intrauterine Growth Restriction (sIUGR)
St. Louis, Missouri (PRWEB) September 24, 2015 -- Using a pencil-tip-sized scope and a small laser fiber, doctors at the St. Louis Fetal Care Institute can now give twins with sIUGR a chance at life outside the womb. The procedure, known as fetoscopic laser coagulation uses a laser to block blood vessels that connect the twins. This is the same fetal surgery technique that is used in twins with twin-to-twin transfusion syndrome (TTTS).
The goal of this new method of managing sIUGR is to ensure that connecting blood vessels do not cause harm to the healthy twin, while allowing the smaller twin to continue at its rate of development.
"The issue of SIUGR is worrisome for the baby with the growth restriction, as spontaneous death can occur in as high as 40 percent of cases, and also for the healthy twin because of the shared blood connections on the placenta," says Mike Vlastos, MD the director of the St. Louis Fetal Care Institute.
sIUGR is a condition that occurs when monochorionic (identical) twins share unequal portions of the placenta. Vessels on the surface of the placenta connect the babies’ circulations. When twins have sIUGR, one baby is normal size, while the other is significantly smaller, as it has difficulty getting enough oxygen and nutrients. This condition occurs in 5-10 percent of identical twins.
During the surgery, the surgeon inserts a pencil-tip-sized scope in the mother’s uterus and examines the entire placenta to find the crossing blood vessels. Once these are all mapped, a tiny laser fiber is inserted and laser energy is used to stop the blood flow between the twins. Separating the twin blood flow is like functionally separating the placenta, allowing each twin to develop independently. It is performed between 15 and 27 weeks gestation. There are less than 20 facilities around the country that offer this surgical option.
"This procedure gives parents the choice to give both babies the chance at life outside the womb," says Vlastos.
Once the condition is diagnosed via ultrasound, the Fetal Care Institute uses a fetal echocardiogram to give them information about the heart function and anatomy. Doppler technology is also used to assess the blood flow to babies’ brains, umbilical cords and other vital organs.
The most commonly used fetal surgery option for sIUGR is cord occlusion. This involves blocking the umbilical cord of the smaller twin, and is not performed at the St. Louis Fetal Care Institute. The fetoscopic laser photocoagulation procedure the Fetal Care Institute offers has the ability to potentially save both the babies. Despite the fetal intervention, often times the smaller, growth restricted twin will have some substantial medical challenges.
Denise Nazzaro, SSM Health Cardinal Glennon Children's Hospital, http://www.stlfetalcare.com, +1 (314) 577-5693, [email protected]
Share this article