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Prenatal diagnosis and management of fetal discordant alpha-thalassaemia in dichorionic diamniotic (DCDA) twins

A 29-year-old nulliparous woman with a dichorionic diamniotic (DCDA) twin pregnancy was referred to our hospital at 16 weeks’ gestation for prenatal diagnosis. She was diagnosed of Haemoglobin H Constant Spring (Hb H CS; --(SEA)/α(CS)α) and her husband of alpha thalassemia-1 trait (--(SEA)/αα). Deta...

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Autores principales: Panchalee, Tachjaree, Ruangvutilert, Pornpimol, Limsiri, Pattarawan, Sutcharitpongsa, Pavit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6202988/
https://www.ncbi.nlm.nih.gov/pubmed/30366888
http://dx.doi.org/10.1136/bcr-2018-224362
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author Panchalee, Tachjaree
Ruangvutilert, Pornpimol
Limsiri, Pattarawan
Sutcharitpongsa, Pavit
author_facet Panchalee, Tachjaree
Ruangvutilert, Pornpimol
Limsiri, Pattarawan
Sutcharitpongsa, Pavit
author_sort Panchalee, Tachjaree
collection PubMed
description A 29-year-old nulliparous woman with a dichorionic diamniotic (DCDA) twin pregnancy was referred to our hospital at 16 weeks’ gestation for prenatal diagnosis. She was diagnosed of Haemoglobin H Constant Spring (Hb H CS; --(SEA)/α(CS)α) and her husband of alpha thalassemia-1 trait (--(SEA)/αα). Detailed ultrasound showed that left twin had fetal anaemia and early signs of hydrops while the right one was normal. Both twins were female. Amniocentesis in each sac was performed for prenatal diagnosis of thalassemia after a proper counselling with the couple. DNA analysis confirmed that the left fetus was affected with haemoglobin Bart’s hydrops fetalis (--(SEA)/--(SEA)) while the right one was alpha thalassemia-1 trait (--(SEA)/αα). Selective feticide with intracardiac injection of KCl was successfully performed on the hydropic fetus. Identification of the affected fetus is crucial for selective termination. Family counselling about the procedure and complications is also necessary.
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spelling pubmed-62029882018-11-05 Prenatal diagnosis and management of fetal discordant alpha-thalassaemia in dichorionic diamniotic (DCDA) twins Panchalee, Tachjaree Ruangvutilert, Pornpimol Limsiri, Pattarawan Sutcharitpongsa, Pavit BMJ Case Rep Reminder of Important Clinical Lesson A 29-year-old nulliparous woman with a dichorionic diamniotic (DCDA) twin pregnancy was referred to our hospital at 16 weeks’ gestation for prenatal diagnosis. She was diagnosed of Haemoglobin H Constant Spring (Hb H CS; --(SEA)/α(CS)α) and her husband of alpha thalassemia-1 trait (--(SEA)/αα). Detailed ultrasound showed that left twin had fetal anaemia and early signs of hydrops while the right one was normal. Both twins were female. Amniocentesis in each sac was performed for prenatal diagnosis of thalassemia after a proper counselling with the couple. DNA analysis confirmed that the left fetus was affected with haemoglobin Bart’s hydrops fetalis (--(SEA)/--(SEA)) while the right one was alpha thalassemia-1 trait (--(SEA)/αα). Selective feticide with intracardiac injection of KCl was successfully performed on the hydropic fetus. Identification of the affected fetus is crucial for selective termination. Family counselling about the procedure and complications is also necessary. BMJ Publishing Group 2018-10-25 /pmc/articles/PMC6202988/ /pubmed/30366888 http://dx.doi.org/10.1136/bcr-2018-224362 Text en © BMJ Publishing Group Limited 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Reminder of Important Clinical Lesson
Panchalee, Tachjaree
Ruangvutilert, Pornpimol
Limsiri, Pattarawan
Sutcharitpongsa, Pavit
Prenatal diagnosis and management of fetal discordant alpha-thalassaemia in dichorionic diamniotic (DCDA) twins
title Prenatal diagnosis and management of fetal discordant alpha-thalassaemia in dichorionic diamniotic (DCDA) twins
title_full Prenatal diagnosis and management of fetal discordant alpha-thalassaemia in dichorionic diamniotic (DCDA) twins
title_fullStr Prenatal diagnosis and management of fetal discordant alpha-thalassaemia in dichorionic diamniotic (DCDA) twins
title_full_unstemmed Prenatal diagnosis and management of fetal discordant alpha-thalassaemia in dichorionic diamniotic (DCDA) twins
title_short Prenatal diagnosis and management of fetal discordant alpha-thalassaemia in dichorionic diamniotic (DCDA) twins
title_sort prenatal diagnosis and management of fetal discordant alpha-thalassaemia in dichorionic diamniotic (dcda) twins
topic Reminder of Important Clinical Lesson
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6202988/
https://www.ncbi.nlm.nih.gov/pubmed/30366888
http://dx.doi.org/10.1136/bcr-2018-224362
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