Syndrome transfuseur transfusé

Centre expert du syndrome transfuseur-transfusé

Les grossesses monochoriales représentent 20% des grossesses gémellaires. Elles sont à « haut risque » et nécessitent une surveillance spécifique ainsi qu’une thérapie prénatale lorsqu’elles se compliquent.
Dans les grossesses monochoriales, les deux fœtus partagent le même placenta. Il existe des anastomoses vasculaires qui relient 2 cordons ombilicaux et qui sont responsables d’échanges entres les deux fœtus. Ce sont ces échanges qui induisent les complications spécifiques telles que le syndrome transfuseur-transfusé. Lorsque ce syndrome apparait, la thérapeutique consiste en la réalisation d’une chirurgie par fœtoscopie pour coagulation au laser des anastomoses placentaires.

Médecin responsable
Pr Yves Ville

En cas
d’urgence

Appeler le 01 44 49 44 00 et demander le poste 98114.

Coordonnées du CRMR

Hôpital universitaire Necker-Enfants malades
Service d’obstétrique

149 rue de Sèvres
75743 PARIS Cedex 15

> Livret d’accueil – patients adultes

  • Complications des grossesses monochoriales :
    – Syndrome transfuseur-transfusé
    – TAPS (twin anemia polycytemia sequence)
  • Retard de croissance sélectif dans une grossesse monochoriale
  • Séquence TRAP (twin reversed arterial perfusion)

D’autres pathologies fœtales peuvent bénéficier d’une thérapeutique prénatale :

  • Sténoses critiques des valves aortiques et pulmonaires
  • Uropathies obstructives basses dans leur forme complète
  • Infection fœtale symptomatique à CMV
  • Hernie de coupole diaphragmatique de pronostic sévère ou intermédiaire
  • Myéloméningocèle de pronostic intermédiaire

Pr Yves Ville, chirurgien en obstétrique et gynécologie

Pr Laurent Salomon, chirurgien en obstétrique et gynécologie

Dr Julien Stirnemann, chirurgien en obstétrique et gynécologie

Dr Claire Colmant, chirurgien en obstétrique et gynécologie

Dr Emmanuel Spaggiari, chirurgien en obstétrique et gynécologie

Dr Imen Mediouni, chirurgien en obstétrique et gynécologie

TTTS1 : Essai clinique randomisé en cluster comparant la coagulation foetoscopique et l’expectative pour le traitement du syndrome transfuseur transfusé de stade 1

Projet STT : suivi pédiatrique des jumeaux transfuseur transfusés entre 4 et 8 ans puis entre 12 et 16 ans

Impact of monochorionicity and twin to twin transfusion syndrome on prenatal attachment, post traumatic stress disorder, anxiety and depressive symptoms

Diplôme inter-universitaire d’échographie gynécologique et obstétricale
Universités Paris Descartes, Paris 12, de Strasbourg, de Brest, de Bordeaux, de Clermont-Ferrand, de Lille, de Lyon, de Marseille, de Nantes,de  Toulouse et de Tours.

Diplôme inter-universitaire de médecine fœtal
Universités Paris Descartes, Paris Sud, de Bordeaux, de Lille, de Montpellier, de Rennes et de Tours.

Master BCPP option « dépistage prénatal » ou « diagnostic médecine foetale »
Universités Paris Descartes

Impact of laser therapy for twin-to-twin transfusion syndrome on subsequent pregnancy. Le Lous M, Mediouni I, Chalouhi G, Salomon LJ, Bussières L, Carrier A, Bernard JP, Ville Y. Prenat Diagn. 2018 Mar;38(4):293-297. doi: 10.1002/pd.5227. Epub 2018 Feb 19.

Preterm premature rupture of membranes is a collateral effect of improvement in perinatal outcomes following fetoscopic coagulation of chorionic vessels for twintwin transfusion syndrome: a retrospective observational study of 1092 cases. Stirnemann J, Djaafri F, Kim A, Mediouni I, Bussieres L, Spaggiari E, Veluppillai C, Lapillonne A, Kermorvant E, Magny JF, Colmant C, Ville Y. BJOG. 2018 Jan 30. doi: 10.1111/1471-0528.15147

Twin-twin transfusion syndrome – What we have learned from clinical trials. Djaafri F, Stirnemann J, Mediouni I, Colmant C, Ville Y. Semin Fetal Neonatal Med. 2017 Dec;22(6):367-375. doi: 10.1016/j.siny.2017.08.005. Epub 2017 Nov 6. Review.

Outcome of triplet pregnancies managed for twin-to-twin transfusion syndrome: A single center experience]. Chalouhi GE, Quibel T, Benzina N, Bernard JP, Essaoui M, Ville Y. J Gynecol Obstet Biol Reprod (Paris). 2016 Oct;45(8):929-935. doi: 10.1016/j.jgyn.2015.08.006. Epub 2016 Mar

Fetal brain imaging following laser surgery in twin-to-twin surgery. Stirnemann J, Chalouhi G, Essaoui M, Bahi-Buisson N, Sonigo P, Millischer AE, Lapillonne A, Guigue V, Salomon LJ, Ville Y. BJOG. 2016 Jun 27. doi: 10.1111/1471-0528.14162

Twin-to-Twin Transfusion Syndrome: From Observational Evidence to Randomized Controlled Trials. Stirnemann JJ, Chalouhi G, Ville Y. Twin Res Hum Genet. 2016 Jun;19(3):268-75. doi: 10.1017/thg.2016.22. Epub 2016 Apr 14. Review.

Impact of Monochorionicity and Twin to Twin Transfusion Syndrome on Prenatal Attachment, Post Traumatic Stress Disorder, Anxiety and Depressive Symptoms. Beauquier-Maccotta B, Chalouhi GE, Picquet AL, Carrier A, Bussières L, Golse B, Ville Y. PLoS One. 2016 Jan 11;11(1):e0145649. doi: 10.1371/journal.pone.0145649. eCollection 2016.

Twin-to-Twin Transfusion Syndrome: From Observational Evidence to Randomized Controlled Trials. Stirnemann JJ, Chalouhi G, Ville Y. Twin Res Hum Genet. 2016 Jun;19(3):268-75. doi: 10.1017/thg.2016.22. Epub 2016 Apr 14. Review.

The Impact of Entry Technique and Access Diameter on Prelabour Rupture of Membranes Following Primary Fetoscopic Laser Treatment for TwinTwin Transfusion Syndrome. Petersen SG, Gibbons KS, Luks FI, Lewi L, Diemert A, Hecher K, Dickinson JE, Stirnemann JJ, Ville Y, Devlieger R, Gardener G, Deprest JA. Fetal Diagn Ther. 2016;40(2):100-9. doi: 10.1159/000441915. Epub 2016 Apr 14.

ISUOG Practice Guidelines: role of ultrasound in twin pregnancy. Khalil A, Rodgers M, Baschat A, Bhide A, Gratacos E, Hecher K, Kilby MD, Lewi L, Nicolaides KH, Oepkes D, Raine-Fenning N, Reed K, Salomon LJ, Sotiriadis A, Thilaganathan B, Ville Y. Ultrasound Obstet Gynecol. 2016 Feb;47(2):247-63. doi: 10.1002/uog.15821. No abstract available

Pulmonary stenosis in complicated monochorionic twin pregnancies: prevalence, management and outcome. Stagnati V, Chalouhi GE, Essaoui M, Giuseppi A, Stirnemann JJ, Le Bidois J, Ville Y. Prenat Diagn. 2015 Nov;35(11):1085-92. doi: 10.1002/pd.4650. Epub 2015 Aug 4..

Active management of selective intrauterine growth restriction with abnormal Doppler in monochorionic diamniotic twin pregnancies diagnosed in the second trimester of pregnancy. Chalouhi GE, Marangoni MA, Quibel T, Deloison B, Benzina N, Essaoui M, Al Ibrahim A, Stirnemann JJ, Salomon LJ, Ville Y. Prenat Diagn. 2013 Feb;33(2):109-15. doi: 10.1002/pd.4031. Epub 2012 Dec 26.

A nomogram for perioperative prognostic risk-assessment in twintwin transfusion syndrome. Stirnemann JJ, Nasr B, Essaoui M, Bussieres L, Ville Y. Prenat Diagn. 2013 Feb;33(2):103-8. doi: 10.1002/pd.4015. Epub 2012 Nov 21.

Timing of delivery following selective laser photocoagulation for twin-to-twin transfusion syndrome. Stirnemann JJ, Quibel T, Essaoui M, Salomon LJ, Bussieres L, Ville Y. Am J Obstet Gynecol. 2012 Aug;207(2):127.e1-6. doi: 10.1016/j.ajog.2012.06.042. Epub 2012 Jun 23.

[Management of twin-to-twin transfusion syndrome]. Chalouhi GE, Deloison B, Ville Y. Gynecol Obstet Fertil. 2012 Mar;40(3):174-81. doi: 10.1016/j.gyobfe.2012.01.009. Epub 2012 Mar 2. French.

Laser therapy for twin-to-twin transfusion syndrome (TTTS). Chalouhi GE, Essaoui M, Stirnemann J, Quibel T, Deloison B, Salomon L, Ville Y. Prenat Diagn. 2011 Jul;31(7):637-46. doi: 10.1002/pd.2803. Epub 2011 Jun 9. Review.

Twin pregnancies: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF). Vayssière C, Benoist G, Blondel B, Deruelle P, Favre R, Gallot D, Jabert P, Lemery D, Picone O, Pons JC, Puech F, Quarello E, Salomon L, Schmitz T, Senat MV, Sentilhes L, Simon A, Stirneman J, Vendittelli F, Winer N, Ville Y; French College of Gynaecologists and Obstetricians. Eur J Obstet Gynecol Reprod Biol. 2011 May;156(1):12-7. doi: 10.1016/j.ejogrb.2010.12.045. Epub 2011 Feb 1. Review.

Specific complications of monochorionic twin pregnancies: twin-twin transfusion syndrome and twin reversed arterial perfusion sequence. Chalouhi GE, Stirnemann JJ, Salomon LJ, Essaoui M, Quibel T, Ville Y. Semin Fetal Neonatal Med. 2010 Dec;15(6):349-56. doi: 10.1016/j.siny.2010.09.003. Epub 2010 Sep 19. Review.

Evaluation of the CHOP cardiovascular score as a prognostic predictor of outcome in twin-twin transfusion syndrome after laser coagulation of placental vessels in a prospective cohort. Stirnemann JJ, Nasr B, Proulx F, Essaoui M, Ville Y. Ultrasound Obstet Gynecol. 2010 Jul;36(1):52-7. doi: 10.1002/uog.7713.

Long-term developmental follow-up of infants who participated in a randomized clinical trial of amniocentesis vs laser photocoagulation for the treatment of twin-to-twin transfusion syndrome. Salomon LJ, Ortqvist L, Aegerter P, Bussieres L, Staracci S, Stirnemann JJ, Essaoui M, Bernard JP, Ville Y. Am J Obstet Gynecol. 2010 Nov;203(5):444.e1-7. doi: 10.1016/j.ajog.2010.08.054.

Direct visual control on cord coagulation using a fetoscopy-guided bipolar forceps. Description of a new technique. Yamamoto M, Barki G, Ville Y. Prenat Diagn. 2010 Feb;30(2):156-8. doi: 10.1002/pd.2419.

Profiling fetal cardiac function in twin-twin transfusion syndrome  Stirnemann JJ, Mougeot M, Proulx F, Nasr B, Essaoui M, Fouron JC, Ville Y. Ultrasound Obstet Gynecol. 2010 Jan;35(1):19-27. doi: 10.1002/uog.7488.

Neurodevelopmental outcome at 2 years in children born preterm treated by amnioreduction or fetoscopic laser surgery for twin-to-twin transfusion syndrome: comparison with dichorionic twins. Lenclen R, Ciarlo G, Paupe A, Bussieres L, Ville Y. Am J Obstet Gynecol. 2009 Sep;201(3):291.e1-5. doi: 10.1016/j.ajog.2009.05.036. Epub 2009 Jul 15.

[Prenatal management of uncomplicated monochorionic biamniotic pregnancies]. Salomon LJ, Stirnemann J, Bernard JP, Essaoui M, Chalouhi G, El Sabbagh A, Ville Y. J Gynecol Obstet Biol Reprod (Paris). 2009 Dec;38(8 Suppl):S45-50. Review. French.

[Twin-to-twin transfusion syndrome: diagnosis and treatment]. Salomon LJ, Ville Y. Bull Acad Natl Med. 2008 Nov;192(8):1575-86; discussion 1586-7. Review. French.

Pseudoamniotic band syndrome: a rare complication of monochorionic twins with fetofetal transfusion syndrome treated by laser coagulation. Winer N, Salomon LJ, Essaoui M, Nasr B, Bernard JP, Ville Y. Am J Obstet Gynecol. 2008 Apr;198(4):393.e1-5. doi: 10.1016/j.ajog.2007.09.030.

Emergency cerclage in cases of twin-to-twin transfusion syndrome with a short cervix at the time of surgery and relationship to perinatal outcome. Salomon LJ, Nasr B, Nizard J, Bernard JP, Essaoui M, Bussieres L, Ville Y. Prenat Diagn. 2008 Dec;28(13):1256-61. doi: 10.1002/pd.2156.

Outcome of anaemic monochorionic single survivors following early intrauterine rescue transfusion in cases of feto-fetal transfusion syndrome. Quarello E, Stirnemann J, Nassar M, Nasr B, Bernard JP, Leleu-Huard F, Ville Y. BJOG. 2008 Apr;115(5):595-601. doi: 10.1111/j.1471-0528.2007.01659.x.

Update on twin-to-twin transfusion syndrome. El Kateb A, Ville Y. Best Pract Res Clin Obstet Gynaecol. 2008 Feb;22(1):63-75. doi: 10.1016/j.bpobgyn.2007.07.002. Epub 2008

A definition of selectivity in laser coagulation of chorionic plate anastomoses in twin-to-twin transfusion syndrome and its relationship to perinatal outcome. Stirnemann JJ, Nasr B, Quarello E, Ortqvist L, Nassar M, Bernard JP, Ville Y. Am J Obstet Gynecol. 2008 Jan;198(1):62.e1-6. doi: 10.1016/j.ajog.2007.06.009.

First-trimester ultrasound examination and the outcome of monochorionic twin pregnancies. El Kateb A, Nasr B, Nassar M, Bernard JP, Ville Y. Prenat Diagn. 2007 Oct;27(10):922-5.

Neonatal outcome in preterm monochorionic twins with twin-to-twin transfusion syndrome after intrauterine treatment with amnioreduction or fetoscopic laser surgery: comparison with dichorionic twins. Lenclen R, Paupe A, Ciarlo G, Couderc S, Castela F, Ortqvist L, Ville Y. Am J Obstet Gynecol. 2007 May;196(5):450.e1-7.

Three-dimensional sonographic assessment of fetal urine production before and after laser surgery in twin-to-twin transfusion syndrome. Yamamoto M, Essaoui M, Nasr B, Malek N, Takahashi Y, Moreira de Sa R, Ville Y. Ultrasound Obstet Gynecol. 2007 Dec;30(7):972-6.

Intertwin discordance in umbilical venous volume flow: a reflection of blood volume imbalance in twin-to-twin transfusion syndrome. Yamamoto M, Nasr B, Ortqvist L, Bernard JP, Takahashi Y, Ville Y. Ultrasound Obstet Gynecol. 2007 Mar;29(3):317-20.

[Specific aspects of monochorionic pregnancies]. Quarello E, Ville Y. Rev Prat. 2006 Dec 31;56(20):2239-47. French.

Intertwin anastomoses in monochorionic placentas after fetoscopic laser coagulation for twin-to-twin transfusion syndrome: is there more than meets the eye? Lewi L, Jani J, Cannie M, Robyr R, Ville Y, Hecher K, Gratacos E, Vandecruys H, Vandecaveye V, Dymarkowski S, Deprest J. Am J Obstet Gynecol. 2006 Mar;194(3):790-5.

Management of fetofetal transfusion syndrome. Robyr R, Quarello E, Ville Y. Prenat Diagn. 2005 Sep;25(9):786-95. Review.

Selective feticide in complicated monochorionic twin pregnancies using ultrasound-guided bipolar cord coagulation. Robyr R, Yamamoto M, Ville Y. BJOG. 2005 Oct;112(10):1344-8.

Endoscopic laser surgery versus serial amnioreduction for severe twin-to-twin transfusion syndrome. Senat MV, Deprest J, Boulvain M, Paupe A, Winer N, Ville Y. N Engl J Med. 2004 Jul 8;351(2):136-44. Epub 2004 Jul 6.

The value of middle cerebral artery peak systolic velocity in the diagnosis of fetal anemia after intrauterine death of one monochorionic twin. Senat MV, Loizeau S, Couderc S, Bernard JP, Ville Y. Am J Obstet Gynecol. 2003 Nov;189(5):1320-4.

Selective feticide in monochorionic pregnancies: toys for the boys or standard of care? Ville Y. Ultrasound Obstet Gynecol. 2003 Nov;22(5):448-50. No abstract available.

Management of single fetal death in twin-to-twin transfusion syndrome: a role for fetal blood sampling. Senat MV, Bernard JP, Loizeau S, Ville Y. Ultrasound Obstet Gynecol. 2002 Oct;20(4):360-3.

Fetal biometric parameters, twin type and birth weight difference. A longitudinal study. Charlemaine C, Duyme M, Ville Y, Aurengo A, Tremblay R, Frydman R, Pons JC. Eur J Obstet Gynecol Reprod Biol. 2000 Nov;93(1):27-32.

[Monochorionic twin pregnancies : dangerous liasons]. Ville Y. J Gynecol Obstet Biol Reprod (Paris). 2000 May;29(3):223-6. French.

Diagnosis of twin reversed arterial perfusion sequence in the first trimester by transvaginal color Doppler ultrasound. Schwärzler P, Ville Y, Moscosco G, Tennstedt C, Bollmann R, Chaoui R. Ultrasound Obstet Gynecol. 1999 Feb;13(2):143-6.

Stuck twin syndrome without signs of twin-to-twin transfusion. Lees CC, Schwärzler P, Ville Y, Campbell S. Ultrasound Obstet Gynecol. 1998 Sep;12(3):211-4.

Twin-to-twin transfusion syndrome: polyhydramnios-associated changes in maternal plasma volume and maternal plasma aldosterone concentrations. A preliminary study. Van Peborgh P, Morineau G, Bussières L, Escourrou P, Ville Y. Fetal Diagn Ther. 1998 May-Jun;13(3):184-6.

Umbilical cord coagulation by operative microendoscopy at 16 weeks’ gestation in an acardiac twin. Hecher K, Hackeloer BJ, Ville Y. Ultrasound Obstet Gynecol. 1997 Aug;10(2):130-2.

Monochorionic twin pregnancies: ‘les liaisons dangereuses’. Ville Y. Ultrasound Obstet Gynecol. 1997 Aug;10(2):82-5. Review

À Necker, le centre expert syndrome transfuseur-transfusé c’est …

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patients suivis au moins une fois par an*
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patientes opérées*
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consultations médicales*
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heures d'enseignement universitaire*
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projets de recherche en cours*

* données pour l’année 2015