American Journal of Obstetrics & Gynecology
Volume 192, Issue 2 , Pages 604-609 , February 2005

Persistent elevation of cell-free fetal DNA levels in maternal plasma after selective laser coagulation of chorionic plate anastomoses in severe midgestational twin-twin transfusion syndrome

  • Tuangsit Wataganara, MD

      Affiliations

    • Division of Genetics, Department of Pediatrics, Obstetrics and Gynecology, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Mass
    • ,
  • Eduard Gratacos, MD

      Affiliations

    • Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
    • ,
  • Jacques Jani, MD

      Affiliations

    • Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Jorge Becker, MD

      Affiliations

    • Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
    • ,
  • Liesbeth Lewi, MD

      Affiliations

    • Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Lisa M. Sullivan, PhD

      Affiliations

    • Department of Biostatistics, Boston University, Boston, Mass
    • ,
  • Diana W. Bianchi, MD

      Affiliations

    • Division of Genetics, Department of Pediatrics, Obstetrics and Gynecology, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Mass
    • Corresponding Author InformationReprint request: Diana W. Bianchi, MD, Division of Genetics, Departments of Pediatrics, Obstetrics and Gynecology, Tufts-New England Medical Center, 750 Washington St, Box 394, Tufts-NEMC, Boston, MA 02111.
    • ,
  • Jan A. Deprest, MD, PhD

      Affiliations

    • Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, Leuven, Belgium

Received 14 March 2004 ,Revised 11 June 2004

References 

  1. Lewi L, Van Schoubroeck D, Gratacos E, Witters I, Timmerman D, Deprest J. Monochorionic diamniotic twins: complications and manangement options. Curr Opin Obstet Gynecol. 2003;15:177–194
  2. De Lia JE, Kuhlmann RS, Harstad TW, Cruikshank DP. Fetoscopic laser ablation of placental vessels in severe previable twin-twin transfusion syndrome. Am J Obstet Gynecol. 1995;172:1202–1211
  3. Quintero RA, Comas C, Bornick PW, Allen MH, Kruger M. Selective versus non-selective laser photocoagulation of placental vessels in twin-to-twin transfusion syndrome. Ultrasound Obstet Gynecol. 2000;16:230–236
  4. Ville Y, Hecher K, Gagnon A, Sebire N, Hyett J, Nicolaides K. Endoscopic laser coagulation in the management of severe twin-twin transfusion syndrome. BJOG. 1998;105:446–453
  5. Hecher K, Plath H, Bregenzer T, Hansmann M, Hackeloer B. Endoscopic laser surgery versus serial amniocentesis in the treatment of severe twin-twin transfusion syndrome. Am J Obstet Gynecol. 1999;180:717–724
  6. Zikulnig L, Hecher K, Brezenger T, Baz E, Hackeloer BJ. Prognostic factors in severe twin-twin transfusion syndrome treated by endoscopic laser surgery. Ultrasound Obstet Gynecol. 1999;14:380–387
  7. Quintero RA, Dickinson JE, Morales WJ, Bornick PW, Bermudez C, Cincotta R, et al. Stage-based treatment of twin-twin transfusion syndrome. Am J Obstet Gynecol. 2003;188:1333–1340
  8. Senat MV, Deprest J, Boulvain M, Paupe A, Winer N, Ville Y. Endoscopic laser surgery versus serial amnioreduction for severe twin-to-twin transfusion syndrome. [abstract] N Engl J Med. 2004;351:136–144
  9. Branisteanu-Dumitrascu I, Deprest JA, Evrard VA, Van Ballaer PP, Van Schoubroeck D, Gratacos E, et al. Time-related cotyledonary effects of laser coagulation of superficial chorionic vessels in an ovine model. Prenat Diagn. 1999;19:205–210
  10. Wataganara T, Bianchi DW. Fetal cell-free nucleic acids in maternal circulation: new clinical applications. Ann N Y Acad Sci. 2004;1022:90–99
  11. Gratacos E, Deprest J. Current experience with fetoscopy and the Eurofoetus registry for fetoscopic procedures. Eur J Obstet Gynecol Reprod Biol. 2000;92:151–159
  12. Wataganara T, LeShane ES, Farina A, Messerlian GM, Lee T, Canick J, et al. Maternal serum cell-free fetal DNA levels are increased in cases of trisomy 13 but not trisomy 18. Hum Genet. 2003;112:204–208
  13. Diehl W, Hecher K, Zikulnig L, Vetter M, Hackeloer BJ. Placental vascular anastomoses visualized during fetoscopic laser surgery in severe mid-trimester twin-twin transfusion syndrome. Placenta. 2001;22:876–881
  14. DePaepe ME, Friedman RM, Poch M, Hansen K, Carr SR, Luks FI. Placental findings after laser ablation of communicating vessels in twin-to-twin transfusion syndrome (TTS). Pediatr Dev Pathol. 2004;7:159–165
  15. Wataganara T, Chen AY, LeShane ES, Sullivan LM, Borgatta L, Bianchi DW, et al. Cell-free fetal DNA levels in maternal plasma after elective first trimester termination of pregnancy. Fertil Steril. 2004;81:638–644
  16. Wataganara T, LeShane ES, Chen AY, Borgatta L, Peter I, Johnson KL, et al. Plasma gamma globin gene expression suggests that fetal hematopoietic cells contribute to the pool of circulating cell-free nucleic acids during pregnancy. Clin Chem. 2004;50:689–693
  17. Lo YM, Zhang J, Leung TN, Lau TK, Chang AM, Hjelm AM. Rapid clearance of fetal DNA from maternal plasma. Am J Hum Genet. 1999;64:218–224
  18. Lau TW, Leung TN, Chan LY, Lau TK, Chan KC, Tam WH, et al. Fetal DNA clearance from maternal plasma is impaired in preeclampsia. Clin Chem. 2002;48:2141–2146
  19. Gratacos E, Van Schoubroeck D, Carreras E, Devlieger R, Roma E, Cabero L, et al. Impact of laser coagulation in severe twin-twin transfusion syndrome on fetal Doppler indices and venous blood flow volume. Ultrasound Obstet Gynecol. 2002;20:125–130
  20. Ng EK, Tsui NB, Lau TK, Leung TN, Chiu RW, Panesar NS, et al. mRNA of placental origin is readily detectable in maternal plasma. Proc Natl Acad Sci U S A. 2003;100:4748–4753

 The Maternal-Fetal Medicine Fellowship (TW) was supported in part by the Anandamahidol Foundation, Thailand. The fellowship (JJ) and the clinical trials were supported by the European Commission (EURO TWIN 2 TWIN, GLC1-CT-2002-01632). L. Lewi is a recipient of a doctoral fellowship of the Flemish Government (VIS/00/009). Funding was also received from The Spanish Fondo de Investigaciones Cientificas (FIS 02/0738 to EG) and the United States National Institutes of Health (N01-HD43204 and R01-HD42053 to DWB).

PII: S0002-9378(04)00777-X

doi: 10.1016/j.ajog.2004.07.019

American Journal of Obstetrics & Gynecology
Volume 192, Issue 2 , Pages 604-609 , February 2005

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