Ultrasonographic Diagnosis of Twin-to-Twin Transfusion Syndrome

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INTRODUCTION:  Twin-twin transfusion syndrome (TTTS) is a typical complication of monochorionic twin pregnancies (MCTP). Placental vessels that communicate in the chorionic plate between donor and recipient, are responsible for the imbalance of blood flow. Circulatory imbalance causes hypovolemia in donor and hypervolemia in recipient fetus. In a typical case, recipient fetus develops polyhydramnios, weight gain, cardiomegaly and hydrops fetalis. In contrast, donor fetus develops oligohydramnios and fetal growth restriction.

AIM:  The objective of this review is to evaluate in detail the main diagnostic aspects and add other important data for diagnosis of TTTS.

SCIENTIFIC BASES:  The main diagnostic event for this condition is based on the ultrasonographic discovery of oligohydramnios-polyhydramnios sequence. Other useful elements for diagnosis, staging and prognosis are fetal urinary bladder visualization, urinary bladder volumen measurements, edema of subcutaneous and/or generalized tissue edema, Doppler flow velocity waves and cardiac evaluation.

CONCLUSION:  Considerations regarding diagnosis of TTTS make it possible to emphasize that role of physicians treating patients with MCTP is to identify ultrasound sequence of oligohydramnios-polyhydramnios. Other ultrasonographic fetal data as fetal urinary bladder visualization, urinary bladder volumen measurements, edema of subcutaneous and/or generalized tissue edema, Doppler flow velocity waves and cardiac evaluation; may help diagnosis, staging and prognosis of TTTS. It is their responsibility to accurately assess severity, therapeutic possibilities and prognosis.

KEY POINTS: · The role of physicians treating patients with MCTP, regarding diagnosis of TTTS, must be to identify ultrasound sequence of oligohydramnios-polyhydramnios.. · Other ultrasonographic fetal data may help diagnosis, staging, and prognosis of TTTS as follows: fetal urinary bladder visualization, urinary bladder volume measurements, edema of subcutaneous and/or generalized tissue edema, Doppler flow velocity waves, and cardiac evaluation.. · It is physicians' responsibility to accurately assess severity, therapeutic possibilities, and prognosis of patients with MCTP and diagnosis of TTTS.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:41

Enthalten in:

American journal of perinatology - 41(2024), 5 vom: 01. Apr., Seite 531-538

Sprache:

Englisch

Beteiligte Personen:

Reyna-Villasmil, Eduardo [VerfasserIn]
Briceño-Pérez, Carlos [VerfasserIn]
Briceño-Sanabria, Juan C [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Review

Anmerkungen:

Date Completed 22.03.2024

Date Revised 02.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1055/s-0042-1744259

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM337946442