Komplikacije monokorijalne blizanačke trudnoće

master's thesis

• Title (english): Complications of monochorionic twins pregnancy
• Author: Trpimir Kovačić
• Mentor: Trpimir Goluža (mentor)
• Committee member: Vesna Elveđi Gašparović (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Trpimir Goluža (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Blizanačka trudnoća označava prisutnost dvaju fetusa tijekom iste trudnoće i predstavlja stanja više stope neonatalnog mortaliteta i morbiditeta u odnosu na jednoplodne trudnoće. Blizanačke trudnoće dijele se prema korionicitetu na dva tipa: bikorionske i monokorionske. Monokorijalne trudnoće stanja su povećane učestalosti specifičnih komplikacija u odnosu na bikorionske trudnoće. Komplikacije monokorijalne trudnoće nastaju kao posljedica jedinstvene vaskularizacije monokorijalne placente i prisutnosti vaskularnih anastomoza preko kojih se ostvaruje izmjena krvi između blizanaca. Sindromi jedinstveni navedenom tipu trudnoća su sindrom blizanačke transfuzije (TTTS), povratna arterijska perfuzija blizanaca (TRAP) i sindrom anemije i policitemije blizanaca (TAPS). Najčešća među navedenim komplikacijama je TTTS - stanje neuravnoteženoga protoka između blizanaca s visokom stopom mortaliteta bez liječenja. TRAP je najteža komplikacija monokrijalne trudnoće, a očituje se postojanjem nevijabilnoga akardijskog fetusa i morfološki normalno razvijenog „pumpajućeg“ fetusa. TAPS je prepoznatljiv kao kronična anemija u „darivatelja“ i policitemija u „primatelja“ . Iako za svaki od sindroma ne postoji optimalan terapijski pristup, pravovremena dijagnoza i provedba preporučenih postupaka liječenja ključni su za sprečavanje intrauterine smrti jednog ili obaju fetusa.

Abstract (english)

Twin pregnancy is a state that represents coexistence of two fetuses during the same pregnancy and is connected with a higher rate of neonatal mortality and morbidity compared to singleton pregnancy. By the chorionicity, twin pregnancies are divided into two types: monochorionic and bichorionic. Monochorionic twin pregnancy is a condition of higher risk for specific complications than in dichorionic ones. Complications of monochorionic twin pregnancy occur due to unique vascularization of monochorionic placenta and presence of vascular anastomosis which allow blood transfer between two fetuses. Syndromes that are specific for those pregnancies are: Twin to Twin Transfusion Syndrome (TTTS), Twin Reversed Arterial Perfusion (TRAP) and Twin Anemia Polycythemia Syndrome (TAPS). TTTS is the most common complication. It is a condition of unbalanced blood flow between twins and if left untreated mortality rate is high. TRAP is the most severe condition of all monochorionic complications. It presents as presence of unviable acardiac fetus and morphologically developed pumping twin. TAPS manifests as chronic anemia in donor twin and polycythemia in recipient. Although, a perfect therapeutic approach does not exist, timely diagnosis and intervention are crucial for prevention of intrauterine demise of one or both twins.

• Keywords: monokrijalna trudnoća; sindrom blizanačke transfuzije; povratna arterijska perfuzija blizanaca; sindrom anemije i policitemije blizanaca
• Language: croatian
• URN:NBN: urn:nbn:hr:105:642582
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-25 11:48:05