11 ian. UNDERSTANDING THE PATHOPHYSIOLOGY OFTHE TWIN-TOTWIN TRANSFUSION SYNDROME
N. Suciu1,2, A.Oncescu1, Andreea-Cătălina Fetecău1, L. Pop1, Oana Toader1,2
1 Departament of Obstetrics and Gynecology, “Alessandrescu-Rusescu” National Institute for Mother and Child Care, Polizu Hospital, Bucharest.
2 Department of Obstetrics and Gynecology, ”Carol Davila” University of Medicine and Pharmacy, Bucharest
Abstract
Twin-to-twin transfusion syndrome (TTTS) also known as twin oligohydramnios-polyhydramnios sequence (TOPS) is considered to be one of the most frequent complications of monochorionic diamniotic pregnancies. The placenta lies at the core of the TTTS pathophysiology and during the past two decades, numerous studies have been carried out in order to help understand the transfusional mechanisms. The placental anastomoses, which are the primary mediators of transfusional imbalance are incapable of fully explaining the disease and also the negative impact it has on both the renal and cardiovascular systems. The current paper is aimed at providing an insight into the placental and fetal pathophysiology of the syndrome after reviewing the current articles published in the literature.
Rezumat
Sindromul transfuzor-transfuzat (TTTS), cunoscut si sub denumirea de secventa oligohidramniospolihidramnios (TOPS) este considerat a fi una dintre cele mai frevvente si severe complicatii ce apar la sarcinile gemelare monocoriale, biamniotice. Placentatia jocă un rol substantial în fiziopatologia sindromului transfuzortransfuzat si, în ultimii 20 de ani, numaroase studii au fost efectuate pentru a ajuta la întelegerea mecanismelor transfuzionale ce stau la baza acestui tip de sindrom. Anastomozele placentare, depistate la sarcinile gemelare cu TTTS si principalii mediatori răspunzători de dezechilibrul transfuzional sunt insuficienti pentru a putea explica aparitia sindromului precum si impactul negativ al acestuia asupra sistemelor renal si cardiovascular fetale. Lucrarea de fată îsi propune să ofere o mai bună cunoastere a fiziopatologiei placentare si fetale ale sindromului după evaluarea articolelor publicate in literatura de specialitate.
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