A Systematic Approach to the Differential Diagnosis and Management of the Complications of Monochorionic Twin Pregnancies

被引：70
作者：
Gratacos, E. [1 ,2 ]
Ortiz, J. U. [1 ,2 ,3 ]
Martinez, J. M. [1 ,2 ]
机构：
[1] Univ Barcelona, Inst Invest Biomed Augusto Pi & Sunyer IDIBAPS, Maternal Fetal Med Dept, ICGON,Hosp Clin, ES-08028 Barcelona, Spain
[2] Ctr Invest Biomed Red Enfermedades Raras CIBERER, Barcelona, Spain
[3] Tech Univ Munich, Frauenklin & Poliklin, Munich, Germany
来源：
FETAL DIAGNOSIS AND THERAPY | 2012年 / 32卷 / 03期
关键词：
Monochorionic twin pregnancy; Twin-twin transfusion syndrome; Twin anemia-polycythemia sequence; Acute feto-fetal transfusion; Selective intrauterine growth restriction; Discordant malformation; INTRAUTERINE GROWTH RESTRICTION; ANEMIA-POLYCYTHEMIA SEQUENCE; UMBILICAL ARTERY DOPPLER; END-DIASTOLIC FLOW; ENDOSCOPIC LASER-SURGERY; PEAK SYSTOLIC VELOCITY; TRANSFUSION SYNDROME; INTERMITTENT ABSENT; DIAMNIOTIC TWINS; PLACENTAL CHARACTERISTICS;
D O I：
10.1159/000342751
中图分类号：
R71 [妇产科学];
学科分类号：
100211 ;
摘要：
Monochorionic (MC) twins represent a significant proportion of perinatal morbidity and mortality. Overall, 1 of 3 MC twin pregnancies will develop complications in relation to the MC placenta and the presence of interfetal placental anastomoses. From a clinical standpoint, these complications can be grouped into four main types of clinical problems: chronic transfusion, acute transfusion, growth discordance, and discordant malformation. Differential diagnosis of MC twin complications is still challenging due to frequent overlap of their clinical signs and the complex relationships between them. Clinical experience demonstrates that most instances of wrong management derive from failure to comply with a basic set of rules for diagnosis and management. In this review, we propose a simplified approach to the understanding of MC twin pregnancy, its potential complications, and the key concepts allowing adequate differential diagnosis and targeted management. Copyright (C) 2012 S. Karger AG, Basel
引用
收藏
页码：145 / 155
页数：11
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