Obstetrics pregnancy ultrasound
Twin to twin transfusion is a serious complication affecting multiple pregnancies and is sometimes referred to as chronic intertwin transfusion syndrome.
Chronic intertwin transfusion syndrome is a complication of monozygotic/monochorionic twins in which intraplacental arterial venous shunts are uncompensated and preferential blood flow exists. Vascular communications are present in virtualy all monochorionic placentas and approximately one third will demonstrate atleast some clinical evidence of the syndrome.
Chronic intertwin syndrome is now diagnosed using ultrasound criteria including:
Marked size disparity in fetuses of the same sex.
Disparity in size between two amniotic sacs
Disparity in size of the Umbilical cords
A single placenta
Evidence of Hydrops in either fetus
Findings of congestive heart failure in recipient
Doppler ultrasound has also been proposed as a tool that may help improve diagnostic accuracy and assess fetal well being.
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