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A CASE STUDY OF TWIN TO TWIN TRANSFUSION SYNDROME

CHITRA A

Abstract


Background Monochorionic twins have a risk of developing twin to twin transfusion syndrome, between 10-15 percent.. The mortality rate reaches up to 80-90 percent, if not treated. Twin to twin transfusion syndrome is characterised by the presence of multiple vascular placental anastomosis. The diagnosis of is primarily by USG through ,identification of peculiar sign, no intertwine dividing membrane, same sex, polyhydramnios of recipient twin, oligohydramnios  anhydramnios of donor twin, IUGR of donor twin,  permanently filled bladder of recipient twin, and slightly filled or empty bladder of donor twin .The severity of Twin to twin transfusion syndrome is established using the Quinteros  staging. RESULTST win to twin transfusion syndrome is treated by several options like fetoscopic laser coagulation of placental vascular anastomosis and serial amniodrainage, selective feticide by cord coagulation, septostomy with or without amniodrainage. Timely diagnosis of TTTS is crucial because delay in diagnosis and treatment increases the  perinatal mortality and morbidity. At the moment the best treatment seems to be the fetoscopic lasercoagulation of placental vessel anastomosis which showed survival rate between 76-88 percent.

 


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