A case report and literature review in twin-twin transfusion syndrome stage III, fetoscopy -guided laser therapy, complicated with ballantyne syndrome and selective IUGR of fetus donor
DOI:
https://doi.org/10.18597/rcog.257Keywords:
Ballantyne syndrome, mirror syndrome, pseudotoxemia, twin-to-twin transfusion syndrome, laser photocoagulationAbstract
Objective: a 21 years old primigravid patient with biamniotic monochorial twin pregnancy and stage III twin-to -twin transfusion syndrome, diagnosed during week 23 of gestation is presented. She was managed with selective, sequential laser photocoagulation of the communicating blood vessels which was complicated by Ballantyne’s syndrome (mirror syndrome) and selective intrauterine growth restriction (IUGR) of the donor fetus. She delivered during week 35 with good perinatal result. The object was to make an updated review of the literature about Ballantyne’s syndrome.
Materials and methods: the PubMed/ MEDLINE, Cochrane databases were searched as well as books on the specialization, related to the term “Ballantyne’s syndrome”, with no restriction regarding publication date.
Conclusion: selective, sequential laser photocoagulation of the communicating blood vessels is the management of choice for twintwin fetus transfusion syndrome. Selective growth restriction of the donor fetus in stage III could be presented in 40% to 70% of cases. Ballantyne’s syndrome could be secondary to placental edema without fetal hydrops; suspecting it, helps to identify which patients could benefit from active management of this pathology.
Author Biographies
Libardo A. Gómez-Castro
Guido Parra
Felipe Vergara
Miguel Parra
Martha Gómez
Rey Cuellar
Rubén Quintero
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