Акушерство и Гинекология Санкт-Петербурга. 2017; : 18-23
Специфические осложнения монохориального многоплодия – фето-фетальный трансфузионный синдром и синдром анемииполицитемии
Аннотация
Фето-фетальный трансфузионный синдром и синдром анемииполицитемии – тяжелые осложнения монохориального многоплодия, связанные с васкулярными анастомозами плаценты, сопровождающиеся высокими перинатальными потерями при отсутствии лечения. В данном обзоре представлены различия в патофизиологии и лечении этих состояний. Оптимальным лечением фето-фетального трансфузионного синдрома является фетоскопическая лазерная коагуляция анастомозов плаценты. Оптимальное лечение синдрома анемии-полицитемии до сих пор неизвестно, применяется выжидательная тактика, внутриматочные переливания крови и фетоскопическая лазерная хирургия.
Список литературы
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24. Ishii K., Chmait R.H., Mart´inez J.M., Nakata M., Quintero R.A. Ultrasound assessment of venous blood flow before and after laser therapy: approach to understanding the pathophysiology of twin-twin transfusion syndrome. Ultrasound Obstet. Gynecol. 2004; 24 (2): 164–168. DOI: 10.1002/uog.1104.
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66. Mihajlov A.V., Romanovskij A.N., Shlykova A.V., Kuznecov A.A., Savel’eva A.A. Single fetal demise in twin. Plod i novorozhdennyj kak pacienty. Pod red. A.V. Mihajlova, D.O. Ivanova. ID “Petropolis”, Sankt-Peterburg; 2015. P. 931–935. Russian.
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Obstetrics and Gynaecology of Saint-Petersburg. 2017; : 18-23
Specific complications of monochorionic pregnancy – twin-to-twin transfusion and twin anemia-polycythemia syndromes
Abstract
Twin-to-twin transfusion syndrome and syndrome of anemia-polycythemia – severe complications of monochorionic multiple pregnancy caused placental vascular anastomosis, associated with high perinatal losses if left untreated. The differences in the pathophysiology and treatment of these conditions is presented in this review . The optimal treatment of twin-twin transfusion syndrome is fetoscopic laser coagulation of placental anastomoses. Optimal treatment of anemia-polycythemia syndrome is still unknown, expectant management, intrauterine blood transfusion and fetoscopic laser coagulation of placental anastomoses are the treatment options.
References
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2. Bajoria R., Wigglesworth J., Fisk N.M. Angioarchitecture of monochorionic placentas in relation to the twin –twin transfusion syndrome [see comments] Am. J. Obstet. Gynecol. 1995; 172 (3): 856–863.
3. Baldwin V. Pathology of multiple pregnancy, in The Textbook of Fetal and Prenatal Pathology. 1991. P. 247–253.
4. Baschat A., Chmait R.H., Deprest J., Gratacos E., Hecher K., Kontopoulos E. et al. Twin-to-twin transfusion syndrome (TTTS). J. Perinat. Med. 2011; 39 (2): 107– 112. DOI: 10.1515/JPM.2010.147.
5. Benirschke K. Multiple gestation: Incidence, etiology and inheritance. Maternal– Fetal Medicine. 1994; P. 575–588.
6. Benirschke K., des Roches Harper V. The acardiac anomaly. Teratology. 1977; 15 (3): 311–316.
7. Carroll S.G., Soothill P.W., Abdel-Fattah S.A., Porter H., Montague I., Kyle P.M. Prediction of chorionicity in twin pregnancies at 10–14 weeks of gestation. BJOG. 2002; 109 (2): 182–186.
8. Chang Y.L., Chmait R.H., Bornick P.W., Allen M.H., Quintero R.A. The role of laser surgery in dissecting the etiology of absent or reverse end-diastolic velocity in the umbilical artery of the donor twin in twin-twin transfusion syndrome. Am. J. Obstet. Gynecol. 2006; 195 (2): 478–483. DOI: 10.1016/j.ajog.2006.02.037.
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10. Chmait R.H., Kontopoulos E.V., Korst L.M., Llanes A., Petisco I., Quintero R.A. Stagebased outcomes of 682 consecutive cases of twin-twin transfusion syndrome treated with laser surgery: the USFetus experience. Am. J. Obstet. Gynecol. 2011; 204 (5): 393. DOI: 10.1016/j.ajog.2011.02.001.
11. Chmait R.H., Rossi A.C., Quintero R.A. Paradoxical scalloped placenta with polyhydramnios in twin-twin transfusion syndrome. J. Matern. Fetal Neonatal Med. 2007; 20 (1): 29–32. DOI: 10.1080/14767050601036287.
12. Cincotta R.B., Gray P.H., Phythian G., Rogers Y.M., Chan F.Y. Long term outcome of twin-twin transfusion syndrome. Arch. Dis. Child. Fetal Neonatal Ed. 2000; 83 (3): F171–F176.
13. Crombleholme T.M., Shera D., Lee H., Johnson M., D’Alton M., Porter F. et al. A prospective, randomized, multicenter trial of amnioreduction vs. selective fetoscopic laser photocoagulation for the treatment of severe twin-twin transfusion syndrome. Am. J. Obstet. Gynecol. 2007; 197 (4): 396.e1–396.e9. DOI: 10.1016/j.ajog.2007.07.020.
14. Deprest J., Jani J., Lewi L., Ochsenbein-Kolble N., Cannie M., Done E. et al. Fetoscopic surgery: encouraged by clinical experience and boosted by instrument innovation. Semin. Fetal Neonatal Med. 2006; 11 (6): 398–412. DOI: 10.1016/j.siny.2006.09.003.
15. Dickinson J.E. Severe twin-twin transfusion syndrome: current management concepts [see comments]. Aust. N. Z. J. Obstet. Gynaecol. 1995; 35 (1): 16–21.
16. Dickinson J.E. Duncombe G.J., Evans Sh.F., French N.P., Hagana R. The long term neurologic outcome of children from pregnancies complicated by twin-totwin transfusion syndrome. BJOG. 2005; 112 (1): 63–68. DOI: 10.1111/j.14710528.2004.00330.x.
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18. Dube J., Dodds L., Armson B.A. Does chorionicity or zygosity predict adverse perinatal outcomes in twins? Am. J. Obstet. Gynecol. 2002; 186 (3): 579–583.
19. Frusca T., Soregaroli M., Fichera A., Taddei F., Villani P., Accorsi P. et al. Pregnancies complicated by Twin–Twin transfusion syndrome: outcome and long–term neurological follow-up. Eur. J. Obstet. Gynecol. Reprod. Biol. 2003; 107 (2): 145–150.
20. Golombeck K., Ball R.H., Lee H., Farrell J.A., Farmer D.L., Jacobs V.R. et al. Maternal morbidity after maternal-fetal surgery. Am. J. Obstet. Gynecol. 2006; 194 (3): 834–839. DOI: 10.1016/j.ajog.2005.10.807.
21. Haverkamp F., Lex C., Hanisch C., Fahnenstich H., Zerres K. Neurodevelopmental risks in twin-to-twin transfusion syndrome: preliminary findings. Eur. J. Paediatr. Neurol. 2001; 5 (1): 21–27. DOI: 10.1053/ejpn.2001.0400.
22. Hecher K. Plath H., Bregenzer T., Hansmann M., Hackeloer B.J. Endoscopic laser surgery versus serial amniocenteses in the treatment of severe twin-twin transfusion syndrome. Am. J. Obstet. Gynecol. 1999; 180 (3, Pt. 1): 717–724.
23. Huber A., Diehl W., Zikulnig L., Bregenzer T., Hackeloer B.J., Hecher K. Perinatal outcome in monochorionic twin pregnancies complicated by amniotic fluid discordance without severe twin-twin transfusion syndrome. Ultrasound Obstet. Gynecol. 2006; 27 (1): 48–52. DOI: 10.1002/uog.2655.
24. Ishii K., Chmait R.H., Mart´inez J.M., Nakata M., Quintero R.A. Ultrasound assessment of venous blood flow before and after laser therapy: approach to understanding the pathophysiology of twin-twin transfusion syndrome. Ultrasound Obstet. Gynecol. 2004; 24 (2): 164–168. DOI: 10.1002/uog.1104.
25. James W. A note on the epidemiology of acardiac monsters. Teratology. 1977; 16: 211–216.
26. Jauniaux E., Holmes A., Hyett J., Yates R., Rodeck C. Rapid and radical amniodrainage in the treatment of severe twin-twin transfusion syndrome. Prenat. Diagn. 2001; 21 (6): 471–476. DOI: 10.1002/pd.96.
27. Kontopoulos E.V., Quintero R.A. Treatment of twin-twin transfusion syndrome: an evidence-based analysis., in twin-twin Transfusion Syndrome. Editor. 2007. P. 127–137.
28. Larroche J.C., Droulle P., Delezoide A.L., Narcy F., Nessmann C. Brain damage in monozygous twins. Biol. Neonate. 1990; 57 (5): 261–278.
29. Lenclen R., Paupe A., Ciarlo G., Couderc S., Castela F., Ortqvist L. et al. Neonatal outcome in preterm monochorionic twins with twin-to-twin transfusion syndrome after intrauterine treatment with amnioreduction or fetoscopic laser surgery: comparison with dichorionic twins. Am. J. Obstet. Gynecol. 2007; 196 (5): 450–457. DOI: 10.1016/j.ajog.2007.01.036.
30. De Lia J., Fisk N., Hecher K. et al. Twin-to-twin transfusion syndrome – debates on the etiology, natural history and management. Ultrasound Obstet. Gynecol. 2000; 16 (3): 210–213.
31. De Lia J.E., Kuhlmann R.S., Harstad T.W., Cruikshank D.P. Fetoscopic laser ablation of placental vessels in severe previable twin-twin transfusion syndrome. Am. J. Obstet. Gynecol. 1995; 172 (4 Pt. 1): 1202–1208; discussion 1208–1211.
32. Livingston J.C., Lim F.Y., Polzin W., Mason J., Crombleholme T.M. Intrafetal radiofrequency ablation for twin reversed arterial perfusion (TRAP): a singlecenter experience. Am. J. Obstet. Gynecol. 2007; 197 (4): 399.e1–3. DOI: 10.1016/j.ajog.2007.07.051.
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