Early symptoms of twin transfusion syndrome?

summary

Twin transfusion syndrome (TTTS) is a serious complication of twin pregnancy. The perinatal mortality is very high. The untreated mortality is 70% ~ 100%. At present, the treatment of TTTS by laser coagulation of placental communicating vessels under fetal endoscopy has become the first choice of many fetal medical centers in the world, which can make the survival rate of at least one fetus reach 75% ~ 80%.

Early symptoms of twin transfusion syndrome?

The difference of the amount of amniotic fluid: the presence of polyhydramnios and oligohydramnios is one of the important diagnostic conditions of TTTS. Among the 7 cases of TTTS, 6 cases were found to have polyhydramnios or oligohydramnios.

The difference between umbilical cord and placenta: the umbilical cord of the recipient is thicker than that of the donor, and sometimes the umbilical cord of the recipient is accompanied by a single umbilical artery. Strong has studied the number of turns of the umbilical cord in TTTS. Within a certain length, the number of turns of the recipient is twice that of the donor. In addition to the diagnosis, the author also thinks that this may be one of the pathological bases of TTTS.

The difference of viscera between two fetuses: zosmer et al. Observed that most of the blood recipients of TTTS may have cardiac dysfunction, and found mild to severe pulmonary stenosis or fatal heart disease in 5 blood recipients of TTTS with polyhydramnios before 25 weeks of gestation by color Doppler ultrasound.

matters needing attention

The earlier TTTS appear, the worse the prognosis. The perinatal mortality rate is almost 100% in the early cases without treatment. In general, the perinatal mortality rate is still 20% - 45% after diagnosis and treatment before 28 weeks of gestation, which is significantly higher than that of twin amniotic sac twin chorionic twins.