Twin to twin transfusion syndrome is a rare complication that can develop in monochorionic twin pregnancies where abnormal placental connections lead to hemodynamic imbalance between the two fetuses. The twin receiving the surplus of blood experiences polyhydramnios whereas the twin donating their blood experiences oligohydramnios. Diagnosis of this syndrome is done based off of the Quintero Staging scale, which consists of five categories of criteria ranging from non-critical diagnoses to diagnoses involving demise of one or two fetuses. The gold standard for treatment involves ablating abnormal vessel connections via a laser therapy. This therapy has shown to reduced short term and long term complications within the twins, and be most efficient at ceasing the disproportionate blood supply between the fetuses. Long term outcomes of twin to twin transfusion syndrome mainly involve neurodevelopmental impairment, but cardiovascular and renal complications can also be present. Adverse neurodevelopmental outcomes should be the ones to most closely monitor postnatally in all TTTS survivors. For recipient twin survivors, cardiovascular outcomes should be most closely watched via blood pressure monitoring and routine echocardiograms. For donor twin survivors, creatinine levels should be routinely checked in order to detect signs of chronic kidney disease in early childhood. Long term outcomes of twin to twin transfusion syndrome still need further investigating due to the difficulty of gathering information postnatally. Limitations that further increase the complexity of this research include lack of education and decreased opportunities for underserved communities to access the advanced medical care required to treat and monitor this disease. Shedding light on this disparity can lead mothers to be more aware of the signs and symptoms of this disease, leading to early detection and more positive outcomes.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/45527 |
| Date | 27 January 2023 |
| Creators | Ansari, Arisha |
| Contributors | Anderson, Deborah, Wisco, Jonathan |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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