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Gender differences in twin-twin transfusion syndrome
J Nores1, A Athanassiou, E Elkadry
1Department of Obstetrics and Gynecology, Tufts University, New England Medical Center, Boston, Massachusetts, USA.
Obstetrics and Gynecology
|November 5, 1997
Summary
Severe twin-twin transfusion syndrome disproportionately affects female twins. This study found an 89% female prevalence, suggesting potential gender-specific biological factors in monochorionic twin pregnancies.
Area of Science:
- Perinatology
- Maternal-Fetal Medicine
- Genetics
Background:
- Twin-twin transfusion syndrome (TTTS) is a serious complication of monochorionic twin pregnancies.
- Severe TTTS presents with specific sonographic and clinical criteria, often leading to significant morbidity or mortality.
- Understanding demographic variations in TTTS can inform diagnosis and management.
Purpose of the Study:
- To investigate potential gender-based disparities in the incidence of severe twin-twin transfusion syndrome.
- To identify if a specific gender is more commonly affected by severe TTTS.
Main Methods:
- Retrospective review of TTTS cases between 1989 and 1996.
- Inclusion criteria required at least five of six sonographic markers for TTTS.
- Severe cases were defined by early onset, specific sonographic findings, or need for intervention.
Main Results:
- Thirty-seven twin pregnancies met the criteria for severe TTTS.
- A significant majority, 33 out of 37 (89%), involved twin pairs that were both female.
- Common findings included single placenta, thin membrane, same gender, polyhydramnios-oligohydramnios, stuck twin, and growth discordance.
Conclusions:
- Severe twin-twin transfusion syndrome demonstrates a notable female preponderance.
- The underlying causes may involve gender-specific placental or fetal factors in monochorionic twins.
- Further research is needed to elucidate the mechanisms behind this observed gender discrepancy.