Evidence on physiopathology
The twin–twin transfusion syndrome (TTTS) (Figure 4.1) occurs in 15% of monochorionic– diamniotic pregnancies,1 with a high perinatal mortality rate.2 These are morphologically normal fetuses, in which the vascular communications in the placenta are thought to be responsible for the development of the disease.
Besides the primary phenomenon, the disease may lead to disruptive lesions in both twins. This chapter will review the evidence for the development of the disease, its complications, and implications in therapeutical approaches. The chapter focuses at defining the clinical problem, the histopathology correlation of the clinical condition, and the ultrasonographic features that support or reject the pathophysiology of the disease. Some particular conditions that lead to TTTS are mentioned in order to understand the disease better.
Besides the primary phenomenon, the disease may lead to disruptive lesions in both twins. This chapter will review the evidence for the development of the disease, its complications, and implications in therapeutical approaches. The chapter focuses at defining the clinical problem, the histopathology correlation of the clinical condition, and the ultrasonographic features that support or reject the pathophysiology of the disease. Some particular conditions that lead to TTTS are mentioned in order to understand the disease better.
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