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Obstetrics and Gynegology2023№2
Acute twin-to-twin transfusion in monochorionic...

Acute twin-to-twin transfusion in monochorionic multiple pregnancy

DOI
https://dx.doi.org/10.18565/aig.2022.259

Mikhailov A.V., Romanovsky A.N., Volchenkova V.E., Kuznetsov A.A., Kyanksep A.N., Saveleva A.A., Osipova A.V., Tcyganova M.K.

1) Maternity Hospital No. 17, Saint Petersburg, Russia; 2) Department of Obstetrics, Gynecology, and Reproductology, Academician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia; 3) S.N. Davydov Department of Obstetrics and Gynecology, I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia; 4) Department of Obstetrics, Gynecology, and Reproductology, Saint Petersburg State University, Saint Petersburg, Russia; 5) D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology, Saint Petersburg, Russia
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.

Authors’ contributions: Mikhailov A.V. – analyzing and generalizing the data available in the literature, editing and processing the manuscript; Romanovsky A.N., Osipova A.V., Kyanksep A.N., Volchenkova V.E. – collecting, analyzing, and generalizing the data available in the literature, writing the text of the article, executing the manuscript; Kuznetsov A.A., Tcyganova M.K., Saveleva A.A. – collecting, analyzing, and generalizing the data available in the literature, editing the manuscript.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The article has been prepared for publication without sponsorship.
For citation: Mikhailov A.V., Romanovsky A.N., Volchenkova V.E.,
Kuznetsov A.A., Kyanksep A.N., Saveleva A.A., Osipova A.V., Tcyganova M.K.
Acute twin-to-twin transfusion in monochorionic multiple pregnancy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (2): 5-11 (in Russian)
https://dx.doi.org/10.18565/aig.2022.259

Keywords

monochorionic twin
acute twin-to-twin transfusion
twin-to-twin transfusion syndrome
twin anemia polycythemia sequence
Full text (in Russian)

References

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Received 03.11.2022

Accepted 13.01.2023

About the Authors

Anton V. Mikhailov, Dr. Med. Sci., Director and Chief of the Maternity Hospital No. 17, 4-1 Lesnozavodskaya str., St. Petersburg, 192174, Russia;
Professor at the Department of Obstetrics, Gynecology and Reproduction, Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia,
6-8 L'va Tolstogo str., St. Petersburg, 197022, Russia; Professor at the Department of Obstetrics and Gynecology, I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia, 47, Piskarevsky Ave., St. Petersburg, 195067, Russia; Chief Researcher, D.O. Ott Institute of Obstetrics, Gynecology and Reproductology,
3 Mendeleevskaya line, St. Petersburg, 199034, Russia, mav080960@gmail.com
Artem N. Romanovsky, PhD, obstetrician-gynecologist, ultrasound diagnostician, Maternity Hospital No. 17, 4-1 Lesnozavodskaya str., St. Petersburg, 192174, Russia;
Associate Professor at the Department of Obstetrics, Gynecology and Reproductology, St. Petersburg State University, 8а, 21-line, St. Petersburg, 199004, Russia.
Veronika E. Volchenkova, obstetrician-gynecologist, ultrasound diagnostician, Maternity Hospital No. 17, 4-1 Lesnozavodskaya str., St. Petersburg, 192174, Russia;
postgraduate of the Department of Obstetrics and Gynecology, I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia,
47, Piskarevskiy Ave., St. Petersburg, 195067, Russia.
Alexandr A. Kuznetsov, PhD, obstetrician-gynecologist, Maternity Hospital No. 17, 4-1 Lesnozavodskaya str., St. Petersburg, 192174, Russia;
assistant of the Department of Obstetrics, Gynecology and Reproduction, Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia,
6-8, L'va Tolstogo str., St. Petersburg, 197022, Russia.
Alexey N. Kyanksep, Head of Neonatology, Maternity Hospital No. 17, Lesnozavodskaya str. 4-1, St. Petersburg, 192174, Russia.
Anna A. Saveleva, ultrasound diagnostician, Maternity Hospital No. 17, 4-1 Lesnozavodskaya str., St. Petersburg, 192174, Russia.
Anastasia V. Osipova, resident at the Department of Obstetrics, Gynecology and Reproductology, St. Petersburg State University, 8а, 21-line, St. Petersburg, 199004, Russia.
Maria K. Tcyganova, resident at the Department of Obstetrics, Gynecology and Reproductology, St. Petersburg State University, 8а, 21-line, St. Petersburg, 199004, Russia.
Corresponding author: Anton V. Mikhailov, mav080960@gmail.com

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