Twin-to-twin transfusion syndrome: a modern view

Bugerenko A.E.

doi:https://doi.org/10.17116/rosakush20212105115

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Abstract:

Twin-to-twin transfusion syndrome is a severe specific complication of mono-chorionic diamniotic twins’ pregnancy and occurs in 10—15% of cases. The review provides information on the pathophysiology of twin-to-twin transfusion syndrome caused by the presence of placental vascular anastomoses. It was specially pointed the early markers of twin-to-twin transfusion syndrome in the first trimester of pregnancy (difference in fetuses’ collar-space thickness, absence or inversion of the A-wave in venous duct in one of the fetuses, fetal growth discordance, anomalies of the umbilical cord placement, concavity of the amniotic septa at the end of first trimester, significant difference in amniotic fluid amount in the second trimester: polyhydramnios in recipient fetus and oligohydramnios in donor fetus). Palliative treatment methods are shown — serial amnioreduction and septostomy. It is emphasized that fetoscopic laser coagulation of anastomoses is directly aimed at eliminating the pathogenesis cause of the disease. The technique of fetoscopic laser coagulation of anastomoses is presented. The studies’ results indicate an improvement in the survival rate of newborns and neurological outcomes with use the sequential selective fetoscopic laser coagulation of anastomoses that is considered the optimal method for treating patients with twin-to-twin transfusion syndrome.

Keywords:

mono-chorionic diamniotic twins

twin-to-twin transfusion syndrome

early markers of twin-to-twin transfusion syndrome

palliative treatment methods

and sequential selective fetoscopic laser coagulation of anastomoses

Authors:

Bugerenko A.E.

Lomonosov Moscow State University Medical Center

SPIN RSCI: 5827-0440
Scopus AuthorID: 57194089658
ORCID: 0000-0001-5691-7588

Received:

26.01.2021

Accepted:

25.02.2021

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References:

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