Archives of Gynecology and Obstetrics

, Volume 292, Issue 6, pp 1183–1184 | Cite as

Visualisation of the vascular equator in twin-to-twin transfusion syndrome by virtual fetoscopy

  • Heron Werner
  • Jorge Lopes Dos Santos
  • Renato Augusto Sá
  • Pedro Daltro
  • Emerson Gasparetto
  • Edson Marchiori
  • Stuart Campbell
  • Edward Araujo JúniorEmail author
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Twin-to-twin transfusion syndrome (TTTS) is a serious complication of monochorionic twin gestation, which has a high risk of perinatal morbidity and mortality. Fetoscopic laser photocoagulation of the vascular anastomoses is the preferred treatment. Nowadays, Solomon technique which consists the vascular coagulation of all anastomoses in the placental equator is the preferable method.


To develop a method of virtual fetoscopy by means of ultrasound and resonance magnetic imaging (MRI) scan data to allow the identification of placental equator.


MRI was performed in a twin monochorionic twin pregnancy with 28 weeks previously treated for TTTS with fetoscopic laser photocoagulation. A three-dimensional (3D) file of the placenta was created from overlapping image layers generated by MRI using Mimics software. Virtual fetoscopy allowed adequate visualization of fetuses, umbilical cord insertion and placental equator.


Virtual fetoscopy is a non-invasive technique which allowed adequate identification of placental equator, and it may be an important learning method to novice fetal endoscopic surgeons in TTTS cases.


Twin-to-twin transfusion syndrome Magnetic resonance imaging Virtual fetoscopy 


Compliance with ethical standards

Conflict of interest


Supplementary material

Supplementary material 1 (MP4 15101 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Heron Werner
    • 1
  • Jorge Lopes Dos Santos
    • 2
  • Renato Augusto Sá
    • 3
  • Pedro Daltro
    • 1
  • Emerson Gasparetto
    • 4
  • Edson Marchiori
    • 4
  • Stuart Campbell
    • 5
  • Edward Araujo Júnior
    • 6
    Email author
  1. 1.Department of RadiologyClínica de Diagnóstico por Imagem (CPDI)Rio de JaneiroBrazil
  2. 2.Instituto Nacional de Tecnologia, Desenho IndustrialRio de JaneiroBrazil
  3. 3.Department of Maternal and ChildFluminense Federal University (UFF)NiteróiBrazil
  4. 4.Department of RadiologyFederal University of Rio de Janeiro (UFRJ)Rio de JaneiroBrazil
  5. 5.Create Health ClinicLondonUK
  6. 6.Department of ObstetricsPaulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP)São PauloBrazil

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