A clinical case of acute progression of feto-fetal transfusion syndrome

• Mark A. Kurtser
• Maria B. Shamanova
• Tatiana O. Normantovich
• Olga L. Malmberg
• Darya I. Sukhanova

Abstract

Background. Pregnancy with monochorionic twins continues to be one of the most pressing problems in obstetrics due to the high risk of specific pregnancy complications associated with the monochorionic type of placentation and non-specific complications (premature birth, preeclampsia) associated with multiple births. Feto-fetal transfusion syndrome (FFTS) is one of the specific complications of pregnancy, leading to high perinatal morbidity and mortality. The existing Quintero classification of the stages of FFTS reflects the linear sequential progression of the stages of the syndrome without indicating a possible atypical or rapid progression of FFTS.

Material and methods. Our article presents a clinical observation of a pregnant patient with monochorionic twins, whose pregnancy was complicated by rapid development of FFTS. We described in detail dynamics of ultrasound examinations, tactics of management of this patient.

Conclusion. Given the possibility of rapid and atypical course of FFTS, ultrasound monitoring (intervals between studies) in monochorionic type of placentation remains one of the most pressing issues in the management of such patients. The appearance of even a slight discordance in the amount of amniotic fluid that does not meet the criteria of stage 1 of FFTS requires a change in the existing management algorithm and ultrasound monitoring after 1–3 days from the appearance of discordance in the amount of amniotic fluid.

Keywords:feto-fetal transfusion; monochorionic twins; pregnancy; feto-fetal transfusion syndrome

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