Therapeutic modalities of twin to twin transfusion syndrome
Twin to twin transfusion syndrome (TTTTS) accounts for approximately 10% of monochorionic twin pregnancies and, if left untreated, is associated with high morbidity and mortality rate. A net transfusion of blood flow from one fetus (donor twin) to the other (recipient twin) via placental vascular an...
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| Format: | Article |
| Language: | English |
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Medicinski fakultet Priština, Društvo lekara Kosova i Metohije Srpskog lekarskog društva
2015-01-01
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| Series: | Praxis Medica |
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| Online Access: | http://scindeks-clanci.ceon.rs/data/pdf/0350-8773/2015/0350-87731501095S.pdf |
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| author | Šulović N. Marjanović S. Šulović Lj. Jovanovic M. Lukač A. |
| author_facet | Šulović N. Marjanović S. Šulović Lj. Jovanovic M. Lukač A. |
| author_sort | Šulović N. |
| collection | DOAJ |
| description | Twin to twin transfusion syndrome (TTTTS) accounts for approximately 10% of monochorionic twin pregnancies and, if left untreated, is associated with high morbidity and mortality rate. A net transfusion of blood flow from one fetus (donor twin) to the other (recipient twin) via placental vascular anastomoses has been supposed as the major etiology of TTTTS. The donor twin becomes hypovolemic and oliguria, oligohydramnios, and a variable degree of growth restriction develop, whereas the recipient twin manifests polyuria, polyhydramnios, and hydrops in response to hypervolemia. TTTTS can be treated by either serial amniocentesis or selective fetoscopic laser coagulation of the communicating vessels. The rationale for removal of large volumes of amniotic fluid is to prevent preterm delivery secondary to polyhydramnios and to improve fetal circulation by reducing pressure on the chorionic plate. On the other hand, the goal of laser therapy is to occlude vascular anastomoses, thereby interrupting intertwin blood exchange. Although laser treatment is associated with increased survival rate and reduced neurologic complications, compared with amnioreduction, it requires highly specialized centers, whereas serial amniocentesis has the advantage of being performed worldwide. Therefore, the optimal treatment for pregnancies complicated with TTTTS is still controversial. |
| first_indexed | 2024-12-20T14:35:54Z |
| format | Article |
| id | doaj.art-43348099ca674e7cb77459905111b659 |
| institution | Directory Open Access Journal |
| issn | 0350-8773 |
| language | English |
| last_indexed | 2024-12-20T14:35:54Z |
| publishDate | 2015-01-01 |
| publisher | Medicinski fakultet Priština, Društvo lekara Kosova i Metohije Srpskog lekarskog društva |
| record_format | Article |
| series | Praxis Medica |
| spelling | doaj.art-43348099ca674e7cb77459905111b6592022-12-21T19:37:27ZengMedicinski fakultet Priština, Društvo lekara Kosova i Metohije Srpskog lekarskog društvaPraxis Medica0350-87732015-01-014419510010.5937/pramed1501095S0350-87731501095STherapeutic modalities of twin to twin transfusion syndromeŠulović N.0Marjanović S.1Šulović Lj.2Jovanovic M.3Lukač A.4University of Priština, Faculty of Medicine, Kosovska Mitrovica, SerbiaUniversity of Priština, Faculty of Medicine, Kosovska Mitrovica, SerbiaUniversity of Priština, Faculty of Medicine, Kosovska Mitrovica, SerbiaZdravstveni centar, GnjilaneZdravstveni centar, Rožaje, Crna GoraTwin to twin transfusion syndrome (TTTTS) accounts for approximately 10% of monochorionic twin pregnancies and, if left untreated, is associated with high morbidity and mortality rate. A net transfusion of blood flow from one fetus (donor twin) to the other (recipient twin) via placental vascular anastomoses has been supposed as the major etiology of TTTTS. The donor twin becomes hypovolemic and oliguria, oligohydramnios, and a variable degree of growth restriction develop, whereas the recipient twin manifests polyuria, polyhydramnios, and hydrops in response to hypervolemia. TTTTS can be treated by either serial amniocentesis or selective fetoscopic laser coagulation of the communicating vessels. The rationale for removal of large volumes of amniotic fluid is to prevent preterm delivery secondary to polyhydramnios and to improve fetal circulation by reducing pressure on the chorionic plate. On the other hand, the goal of laser therapy is to occlude vascular anastomoses, thereby interrupting intertwin blood exchange. Although laser treatment is associated with increased survival rate and reduced neurologic complications, compared with amnioreduction, it requires highly specialized centers, whereas serial amniocentesis has the advantage of being performed worldwide. Therefore, the optimal treatment for pregnancies complicated with TTTTS is still controversial.http://scindeks-clanci.ceon.rs/data/pdf/0350-8773/2015/0350-87731501095S.pdfamniocentesisseptostomy. amnioreductionselective feticidfetal and neonatal survivallaser therapyneurologic morbiditytwin-twin transfusion syndrome |
| spellingShingle | Šulović N. Marjanović S. Šulović Lj. Jovanovic M. Lukač A. Therapeutic modalities of twin to twin transfusion syndrome Praxis Medica amniocentesis septostomy. amnioreduction selective feticid fetal and neonatal survival laser therapy neurologic morbidity twin-twin transfusion syndrome |
| title | Therapeutic modalities of twin to twin transfusion syndrome |
| title_full | Therapeutic modalities of twin to twin transfusion syndrome |
| title_fullStr | Therapeutic modalities of twin to twin transfusion syndrome |
| title_full_unstemmed | Therapeutic modalities of twin to twin transfusion syndrome |
| title_short | Therapeutic modalities of twin to twin transfusion syndrome |
| title_sort | therapeutic modalities of twin to twin transfusion syndrome |
| topic | amniocentesis septostomy. amnioreduction selective feticid fetal and neonatal survival laser therapy neurologic morbidity twin-twin transfusion syndrome |
| url | http://scindeks-clanci.ceon.rs/data/pdf/0350-8773/2015/0350-87731501095S.pdf |
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