{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T13:54:58Z","timestamp":1769003698745,"version":"3.49.0"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,6,27]],"date-time":"2014-06-27T00:00:00Z","timestamp":1403827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the incidence and consequences of \u2018misdiagnosed\u2019 cases of twin\u2013twin transfusion syndrome (<jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Chorionicity and referral diagnoses were reviewed in pregnant women with monochorionic twin pregnancies complicated by <jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content> treated with fetoscopic laser ablation. \u2018Misdiagnosed\u2019 cases, defined as failure to correctly identify chorionicity and\/or to diagnose <jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content> prior to referral, were compared with cases in whom chorionicity and <jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content> were diagnosed correctly. <jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content> stage, gestational age at referral, overall survival, fetal and perinatal mortality, gestational age at delivery, operating time and maternal complications were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Failure to identify monochorionicity and\/or <jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content> was observed in 33% (107\/323) of referrals to our center. Compared with cases in whom chorionicity and <jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content> were correctly diagnosed, misdiagnosed patients were referred at a more advanced stage of disease (Stage <jats:styled-content style=\"fixed-case\">IV TTTS<\/jats:styled-content>: 16.8% <jats:italic>vs<\/jats:italic> 7.9%, <jats:italic>P<\/jats:italic>\u2009=\u20090.014) and later in pregnancy (gestational age at laser: 20.9\u2009weeks <jats:italic>vs<\/jats:italic> 20.1\u2009weeks, <jats:italic>P<\/jats:italic>\u2009=\u20090.018). They also delivered more prematurely (30.3\u2009weeks' gestation <jats:italic>vs<\/jats:italic> 31.5\u2009weeks' gestation, <jats:italic>P<\/jats:italic>\u2009=\u20090.04) and fetal and neonatal mortality were higher (neonatal death within 7 days: 19.6% <jats:italic>vs<\/jats:italic> 6.0%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). When the diagnosis was incorrect, major maternal complications and intensive care unit admissions were increased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Poor recognition of chorionicity in the first trimester of pregnancy might lead to inadequate ultrasound follow up (failure to assess every 2\u2009weeks) and patient education. Early accurate recognition of both chorionicity and <jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content>, with timely referral to a fetal therapy center, are key to ensuring optimal maternal and fetal outcomes. Copyright \u00a9 2014 ISUOG. Published by John Wiley &amp; Sons Ltd<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.13328","type":"journal-article","created":{"date-parts":[[2014,2,12]],"date-time":"2014-02-12T06:49:52Z","timestamp":1392187792000},"page":"205-209","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Twin\u2013twin transfusion syndrome: a frequently missed diagnosis with important consequences"],"prefix":"10.1002","volume":"44","author":[{"given":"D.","family":"Baud","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, Mount Sinai Hospital University of Toronto  Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Windrim","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Mount Sinai Hospital University of Toronto  Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Van Mieghem","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Mount Sinai Hospital University of Toronto  Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Keunen","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Mount Sinai Hospital University of Toronto  Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Seaward","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Mount Sinai Hospital University of Toronto  Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Mount Sinai Hospital University of Toronto  Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,6,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2012.02.006"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2012.03.005"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3819"},{"key":"e_1_2_6_5_1","unstructured":"National French College in Obstetrics and Gynecology.Twin pregnancies: French 2009 guidelines.http:\/\/www.cngof.asso.fr\/D_TELE\/RPC_Gemel_en.pdf."},{"key":"e_1_2_6_6_1","author":"Royal College of Obstetricians and Gynaecologists","year":"2008","journal-title":"Green\u2010top Guideline No. 51: Management of Monochorionic Twin Pregnancy"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)34916-7"},{"key":"e_1_2_6_8_1","unstructured":"RANZCOG College Statement: C\u2010Obs 42.Management of Monochorionic Twin Pregnancy.http:\/\/www.ranzcog.edu.au\/college\u2010statements\u2010guidelines.html."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.02.001"},{"key":"e_1_2_6_10_1","unstructured":"Statistics Canada(2011).Births \u2010 2008.www.statcan.gc.ca\/pub\/84f0210x\/84f0210x2008000\u2010eng.pdf."},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14237-7"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-12-103"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200292"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032597"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.03.042"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.11.027"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2012.31.6.941"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.08.054"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.08.041"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318195873e"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.05.034"},{"key":"e_1_2_6_22_1","unstructured":"Multiple birth website:http:\/\/multiplebirthscanada.org\/mbc_factsheets\/FS\u2010GL_TTTS.pdf."},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31820292ec"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12060"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.13328","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.13328","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T15:12:23Z","timestamp":1696518743000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.13328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6,27]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2014,8]]}},"alternative-id":["10.1002\/uog.13328"],"URL":"https:\/\/doi.org\/10.1002\/uog.13328","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,6,27]]},"assertion":[{"value":"2013-11-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-01-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-06-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}