Acute twin-to-twin transfusion in monochorionic multiple pregnancy

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Abstract

The paper provides an overview of modern concepts of different forms of twin-to-twin transfusion in monochorionic multiple pregnancy. It deals with diagnostic criteria for acute twin-to-twin transfusion during monochorionic twin delivery. The pathogenetic mechanisms of risk factors for acute twin-to-twin transfusion are considered. The differential diagnosis in chronic (twin-to-twin transfusion syndrome, twin anemia polycythemia sequence) and acute (single fetal death in twin pregnancy, placentofetal and acute twin-to-twin transfusions) forms of twin-to-twin transfusion is discussed in detail.

The possibility of predicting and preventing the development of acute twin-to-twin transfusion during childbirth has not been now defined; however, it is assumed that in some cases the changes in the cardiotocographic heart rate patterns may suspect specific disorders and make a timely delivery decision to minimize both antenatal losses and neonatal morbidity and mortality rates. The review gives possible approaches to postnatal correction for neonatal hematological disorders due to acute bypass surgery during monochorionic twin delivery.

Conclusion: Further investigations are needed to clarify diagnostic criteria and risk factors for acute twin-to-twin transfusion and optimal delivery tactics and to study long-term consequences for the health of children with this complication of monochorionic multiple pregnancy.

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About the authors

Anton V. Mikhailov

Maternity Hospital No. 17; Academician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia; I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia; D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology

Author for correspondence.
Email: mav080960@gmail.com

Dr. Med. Sci., Director and Chief; Professor at the Department of Obstetrics, Gynecology and Reproduction; Professor at the Department of Obstetrics and Gynecology; Chief Researcher

Russian Federation, Saint Petersburg; Saint Petersburg; Saint Petersburg; Saint Petersburg

Artem N. Romanovsky

Maternity Hospital No. 17; Saint Petersburg State University

Email: mav080960@gmail.com

PhD, obstetrician-gynecologist, ultrasound diagnostician; Associate Professor at the Department of Obstetrics, Gynecology and Reproductology

Russian Federation, Saint Petersburg; Saint Petersburg

Veronika E. Volchenkova

Maternity Hospital No. 17; I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia

Email: mav080960@gmail.com

obstetrician-gynecologist, ultrasound diagnostician; postgraduate of the Department of Obstetrics and Gynecology

Russian Federation, Saint Petersburg; Saint Petersburg

Alexandr A. Kuznetsov

Maternity Hospital No. 17; Academician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Email: mav080960@gmail.com

PhD, obstetrician-gynecologist, Maternity Hospital No. 17; assistant of the Department of Obstetrics, Gynecology and Reproduction

Russian Federation, Saint Petersburg; Saint Petersburg

Alexey N. Kyanksep

Maternity Hospital No. 17

Email: mav080960@gmail.com

Head of Neonatology

Russian Federation, Saint Petersburg

Anna A. Saveleva

Maternity Hospital No. 17

Email: mav080960@gmail.com

ultrasound diagnostician

Russian Federation, Saint Petersburg

Anastasia V. Osipova

Saint Petersburg State University

Email: mav080960@gmail.com

resident at the Department of Obstetrics, Gynecology and Reproductology

Russian Federation, Saint Petersburg

Maria K. Tcyganova

Saint Petersburg State University

Email: mav080960@gmail.com

resident at the Department of Obstetrics, Gynecology and Reproductology

Russian Federation, Saint Petersburg

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