Abstract:

Twin-twin transfusion syndrome (TTTS) is a devastating complication of monochorionic twin pregnancy and remains a major challenge for worldwide fetal medicine specialists. In TTTS, intertwin transfusion through vascular anastomoses in the shared placenta leads to severe hemodynamic imbalance, which is the main cause of perinatal death. Approximately 10%-15% of all monochorionic diamniotic twins develop TTTS, which usually occurs between the 16th and 26th weeks of gestation, the type, number and diameter of these anastomoses determines the risk profile. Advancements in antenatal management have led to increased perinatal survival and a decreased incidence of neonatal complications, including brain injury and neurodevelopmental impairment. Therefore, early detection, rigorous monitoring, appropriate treatment, prolonging the gestational age as much as possible, and choosing the right time to terminate the pregnancy are the keys to reducing the mortality of monochorionic diamniotic twin. This article analyzes the pathogenesis, prediction, diagnosis and treatment of TTTS, and summarizes the long-term nervous system damage of surviving fetuses after laser treatment.

Key words: Fetofetal transfusion, Forecasting, Diagnosis, Therapy, Prognosis