58 — 8 (46) 2022 — R.B. Yusupbaev, A.A. Erkhanova, FETO-FETAL TRANSFUSION SYNDROME: MODERN METHODS OF TREATMENT

FETO-FETAL TRANSFUSION SYNDROME: MODERN METHODS OF TREATMENT

R.B. Yusupbaev, Republican specialized scientific and practical medical center of obstetrics and gynecology

A.A. Erkhanova, Family Polyclinic № 61

Resume

The presented review discusses the problem of perinatal mortality associated with the development of feto-fetal transfusion syndrome in multiple monochorial pregnancies. Despite the great therapeutic advances achieved in recent years, feto-fetal transfusion syndrome leads to perinatal losses and a high incidence of newborns in 56-100% of observations of multiple monochorial pregnancy.

The article discusses the most modern approaches to the diagnosis of this complication, as well as current methods of treatment of pregnant women with diagnosed feto-fetal transfusion syndrome. For the correction of feto-fetal transfusion syndrome, fetoscopic laser coagulation of placental anastomoses, amniodeduction, selective reduction of one fetus from twins or termination of pregnancy are used. The review compares these treatments depending on the stage of feto-fetal transfusion syndrome and various factors affecting the choice of therapeutic tactics.

Keywords: multiple pregnancy, monochorial twins, feto-fetal transfusion syndrome, fetoscopic laser coagulation of placental anastomoses, serial amnioreduction, selective elimination.

First page

345

Last page

352

For citation: R.B. Yusupbaev, A.A. Erkhanova, FETO-FETAL TRANSFUSION SYNDROME: MODERN METHODS OF TREATMENT //New Day in Medicine 8(46)2022 345-352 https://l.clck.bar/6c400

LIST OF REFERENCES:

  1. A clinical case of development in childbirth of anemia-polycythemia syndrome in feto-fetal syndrome of stage I after amnioreduction. St. Petersburg State Budgetary Institution of Health Care Maternity Hospital No. 17, 2017.
  2. Aitov A.E., Bashmakova N.V., Chistyakova G.N., Remizova I.I., Giniyatova A.A. Influence of pathological attachment of the umbilical cord on the outcomes of monochorial pregnancy. Perinatal medicine – from origins to the present: materials of the IX conference with international participation, October 13-14, 2017, Yekaterinburg. 2017;8-10.
  3. Baranov I.I., Tokova Z.Z., Tadevosyan A.A. Perinatal outcomes in multiple monochorial pregnancies. // Obstetrics and Gynecology. 2012; 1:98-102.
  4. Bermudes C, Becerra CH, Bornick PW. Plasental types and twin-twin transfusion syndrome. // Am J Obstetr Gynecol. 2009; 187:489-394.
  5. Campbell S. Opinion: twin-to-twin transfusion syndrome: debates on the etiology, natural history and management. // Ultrasound Obstet Gynecol. 2000; 16:210-213.
  6. Cavicchioni O., Yamamoto M., Robyr R., Takahashi Y., Ville Y. Intrauterine fetal demise following laser treatment in twin-to-twin transfusion syndrome. // Am J Obstet Gynecol. 2006; 113:590.
  7. Chang Y.L. 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.
  8. Chmait R.H., Korst L.M., Llanes A. Stage-based outcomes of 682 consecutive cases of twin-twin transfusion syndrome treated with laser surgery: the USFetus experience. // Am J Obstet Gynecol. 2011; 204:5:393-398.
  9. Crombleholme T.M., Shera D., Lee H., Johnson M., D’Alton M., Porter F. 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. https://doi.org/10.1016/j.ajog.2007.07.020
  10. Deprest J., Jani J., Lewi L., Ochsenbein-Kclble N., Cannie M., Dony E. Fetoscopic surgery: encouraged by clinical experience and boosted by instrument innovation. Semin Fetal Neonatal Med. 2006; 11:6:398-412. https://doi.org/10.1016/j.siny.2006.09.003
  11. Dodd G.M. Specialised antenatal elimis or women with a multiple pregnancy to improve mathernal and infant outcomes. Cochran Database of systematic Reviews. 2008; Issue 4.
  12. Huber A., Diehl W., Zikulnig L., Bregenzer T., Hackelfer 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.
  13. Khalil A., Rodgers M., Baschat A., Bhide A., Gratacos E., Hecher K., Kilby M.D., Lewi L., Nicolaides K.H., Oepkes D., Raine-Fenning N., Reed K., Salomon L.J., Sotiriadis A., Thilaganathan B., Ville Y.. ISU-OG Practice Guidelines: role of ultrasound in twin pregnancy. // Ultrasound Obstetr Gynecol. 2016; 47:247-263.
  14. Krasnopolsky V.I., Novikova S.V., Kapustina M.V. Modern problems of multiple pregnancy. // Russian Bulletin of obstetrician-gynecologist. 2009; 9:2:79-81.
  15. Krasnopolsky V.I., Novikova S.V., Tsivtsivadze E.B., Zharova A.A. Management of pregnancy and childbirth in multiple pregnancies. // Almanac of Clinical Medicine. 2015; 37:32-40.
  16. Krut Yu.Ya., Babinchuk Ya.V. Multiple pregnancy. A modern view of the problem. // Women’s health. 2013; 21:6:83-85.
  17. Lenclen R., Paupe A., Ciarlo G., Couderc S., Castela F., Ortqvist L. 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. https://doi.org/10.1016/j.ajog.2007.01.036
  18. Lewi L., Jani J., Blickstein I. The outcome of monochorionic diamniotic twin gestations in the era of invasive fetal therapy: a prospective cohort study. // Am J Obstet Gynecol. 2008; 199:514.
  19. 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. https://doi.org/10.1016/j.ajog.2007.07.051
  20. Lopriore E., Slaghekke F., Middeldorp J.M., Klumper F.J., Oepkes D., Vandenbussche F.P. Residual anastomoses in twin-to-twin transfusion syndrome treated with selective fetoscopic laser surgery: localization, size, and consequences. Am J Obstet Gynecol. 2011; 201:1:66.

file

download