VP22.07: Twin reversed arterial perfusion sequence: a case report
Bibliographic record
Abstract
This anastomotic artery was cauterised under ultrasound guidance using diode laser via a 18G spinal needle.Intracardiac transfusion was performed on the next day using a 22G needle directed to fetal right ventricle.Pre-transfusion hemoglobin was 4.2 g/dL and hematocrit was 10.5%.4.5ml blood with hematocrit of 80% was transfused smoothly.Post-transfusion hemoglobin was 12.6 g/dL and hematocrit was 37.2%.MCA PSV was reduced to 0.9 MoM.Fetal hydrops resolved gradually and MCV PSV remained normal.Fetal echocardiogram and MRI were normal.A loop of prominent bowel was noticed since 23 weeks of gestation and this was progressively dilated to 1.72cm at 33 weeks of gestation.The patient went into preterm labour at 34 weeks and 2 days delivering a baby boy of 1960 gram vaginally.Laparotomy showed Type 4 intestinal atresia with resection of multiple atretic segments of small bowel and primary anastomosis was performed.A second laparotomy was required on day 34 for resection of rectal atresia.Bowel function returned to normal afterwards.This is the first reported case illustrating the combined role of interstitial laser in cauterisation of placental anastomosis and intrauterine intracardiac transfusion to rescue a fetus at 15 weeks of gestation suffering from fetal anemia secondary to demise of monochorionic co-twin.Bowel atresia may present early as fetal ascites and may not be preventable.Co-twin survivor requires detailed ultrasound assessment for placental anastomosis, fetal anemia, neurological and other hypoxic insults.VP22.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.009 | 0.006 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".