Abstract
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.
Keywords
twin-twin transfusion syndrome - twin pregnancy - prenatal diagnosis - ultrasound
- complications
