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Twin-twin transfusion syndrome: sonographic findings
D L Brown1, C B Benson, S G Driscoll
1Department of Radiology, Harvard Medical School, Boston, MA 02115.
Radiology
|January 1, 1989
Summary
Twin-twin transfusion syndrome, a complication of monochorionic twins, significantly increases risks. Ultrasound can identify key signs like discordant fetal size and amniotic fluid differences, aiding early diagnosis and management.
Area of Science:
- Perinatology
- Maternal-Fetal Medicine
- Medical Imaging
Background:
- Twin-twin transfusion syndrome (TTTS) is a severe complication unique to monochorionic twins.
- TTTS leads to significantly higher rates of fetal/neonatal death and perinatal morbidity compared to uncomplicated twin pregnancies.
Purpose of the Study:
- To present sonographic findings in ten cases of twin-twin transfusion syndrome.
- To correlate sonographic findings with pathological and laboratory evidence of TTTS.
- To highlight the diagnostic utility of ultrasound in identifying TTTS.
Main Methods:
- Retrospective analysis of ten cases of twin-twin transfusion syndrome.
- Sonographic evaluation of fetal size, amniotic fluid volume, and fetal condition.
- Confirmation of diagnosis through placental pathology and/or laboratory findings.
Main Results:
- All cases involved diamniotic twins with varying severity of TTTS.
- Common sonographic findings included discordant fetal size and unequal amniotic fluid volumes.
- Severe cases presented with recipient hydrops or a "stuck" donor fetus; four cases resulted in intrauterine fetal demise.
Conclusions:
- Familiarity with sonographic patterns is crucial for in utero diagnosis of TTTS.
- Early sonographic detection enables timely intervention and management strategies.
- Ultrasound plays a vital role in identifying TTTS and guiding clinical decisions.