Syndrome of twins

Syndrome of twins's disease overview

Synthesis syndrome of twins , also known as Twin -Twin Transfusion Syndrome -TTTS occurs during pregnancy when the mother is pregnant with the twins and eggs and shares a cake, together, is a serious disorder. 

Song Tha blood transfusion syndrome I occurs in the event of an abnormal vascular connection phenomenon formed in the placenta and the condition of uneven distribution blood in the middle of the The fetus occurs. This leads to a baby that this twin child is called the fetus, will transferred blood through the arteries to the vegetable cake, and does not receive enough blood containing nutrients and oxygen back from vegetable cakes. Through veins. Meanwhile, the other child is a fetus, which will receive more blood through veins, compared to the amount of blood that the other baby transmits through the arteries. Therefore, the fetus will usually be smaller and lack of oxygen, as well as nutrients. Meanwhile the fetus will receive a lot of blood, so the circulatory system always has to work, leading to overload, impaired cardiovascular function. This is a very dangerous condition for both fetuses.

Syndrome of twins (TTTS) due to the connection of arteries and veins leads to a hemodynamic imbalance between fetus and pregnancy. Moreover, the TTTS is also known by the difference in volume between the two amniotic chambers, amniotic fluid and amniotic fluid (Tops)

When suffering from twins blood transfusion syndrome if left untreated, 90-100% of the fetus will die. If one of the two fetuses, the remaining 25% of the fetus suffered from severe nerve sequelae. The incidence of twins blood transfusion syndrome is 0.1-1.9/1000 babies born.

Twin blood transfusion syndrome (TTTS) is garded by the Genet Information Center and Rare Gard Center of the National Center for Advanced Science and Applied Science. Heat and rare, limited in treatment.

The consequence of having twins blood transfusion syndrome is

  • Premature birth
  • Infections, ovs
  • Fetal heart failure, due to heart failure, the pregnancy will die
  • Anemia, deficiency of fetal oxygen leads to death due to vegetable failure or chronic anemia.
  • The risk of nervous system damage is 25% for the remaining pregnancy

    • Causes of Syndrome of twins's disease

    The cause of Most of the blood transfusion syndrome (TTTS) is mostly caused by the consequences of vegetable cakes that appear abnormalities in the blood vessels, when the blood supply of the blood supply One child is moved to the other child thanks to the placenta.

    This leads to both children with problems, depending on the amount of blood transmitted from one fetus to another. The fetus for blood may be too little blood, while the other fetus receives blood, it may have too much blood.

    There are also a number of other causes of twins blood transfusion syndrome but so far it is still unknown.

    Symptoms of Syndrome of twins's disease

    Symptoms of twins blood transfusion syndrome are shown the condition of a fetus. Also known as fetus for perfusion deficiency and lead to dehydration, less water

    The fetus receives blood will usually be larger, red skin and have more blood, blood pressure is usually higher, these fetuses often have too much blood and can lead to heart failure because of the high blood volume leading to The heart must work a lot. Therefore, this infant may need medicine to enhance the function of the heart.

    The opposite twins are the name of the twins and eggs but the size of the two fetuses is not equal.

    A pregnant mother with twins with twins can have the following symptoms:

  • There is a feeling of rapid growth of the uterus.
  • The uterus is larger than the term
  • Abdominal pain, spasms or angina
  • Sudden increase in body weight
  • The hands and feet are swollen at the beginning of pregnancy

    • Vomiting

    Severe edema

    Hypertension

    In addition, the location of each person is different so there may be other symptoms that are not mentioned above due to its popularity. So when there is any unusual manifestation or the above symptoms, it is necessary to notify the doctor to get appropriate treatment.

    People at risk for Syndrome of twins's disease

    The risk of having twins blood transfusion syndrome are mothers with multiple pregnancy and a vegetable cake. This type of pregnancy can be detected early during pregnancy, thanks to regular ultrasound. Therefore, pregnant mothers need regular ultrasound during pregnancy to control the size and health status of the fetus in the abdomen.

    Prevention of Syndrome of twins's disease

    Suitable living mode and living habits can help pregnant mothers manage twins.

    Care at home for women is very important, including:

  • To reduce the pressure on the cervix is ​​in pregnancy, women need to rest in bed or horizontal, lying on one side of the sofa, floor or bed, even when Do not suffer from twins or if they are suffering from
  • Besides, the lying position also helps the woman to improve the amount of blood to the uterus and the kidneys. Because the uterus is where the two fetuses suffer from twins blood transfusion syndrome are facing abnormalities in the placenta. And the kidney is a place to help the woman release excess water.
  • Nutrition plays a very important role. Anemia and protein deficiency are common in the fetus suffering from twins blood transfusion syndrome in the middle of pregnancy. This condition can affect the fetal body. Nutrition supplement is a useful nutritional therapy for women. This nutritional therapy shows improving fatigue and increasing energy for the mother, moreover, improving the symptoms of the fetal twins blood transfusion syndrome, reducing multiple amniotic fluid and reducing demand. invasive intervention.

    • In order to prevent the twin blood transfusion syndrome, the mother is pregnant since the fetus is 16 weeks until the end of pregnancy should go to the weekly ultrasound to monitor the association. proof. Even when the warning signs of the syndrome have decreased, the mother should continue to do ultrasound.

    Planning and regularly going to prenatal check -up is an extremely important thing in early detection of twins blood transfusion syndrome. If the twins are pregnant and the two fetuses share the same vegetable cake, they must regularly ultrasound and prenatal screening.

    If a pregnant mother is at high risk of twins blood transfusion syndrome, the doctor may give a separate menu and add a few vitamins for the mother to take supplements. Because according to the researchers of the twin blood transfusion association shows that the mother's nutrition is related to the twin blood transfusion syndrome.

    Diagnostic measures for Syndrome of twins's disease

    Medical techniques used for diagnosis of twin blood transfusion syndrome :

    Syndrome of twins is usually diagnosed with ultrasound during pregnancy.

    is based on the level of amniotic fluid surrounding each fetus. To respond to oxygen and nutrients, the kidneys of the fetus transmits a lot of blood may be stopped working and leads to amniotic fluid. Meanwhile, the other fetus is the one who receives more blood will increase the amount of urine excreted to be able to treat too much blood the fetus receives. This leads to the amount of amniotic fluid surrounding the fetus will usually be more.

    There is also another sign to diagnose the twin blood transfusion syndrome is the difference in the size of each fetus. But this is a method that cannot clearly diagnose this condition. Because one fetus may develop and be larger and the other fetus may be medium size.

    Amniocentesis is one of the prenatal tests that can help diagnose the twin blood transfusion syndrome.

    After being born, children will receive tests such as:

  • Blood clotting tests, including the part time thromboplasin (PTT) and prothrombin (PT)

    • To determine the electrolyte balance requires a comprehensive metabolic table.

  • Total test

  • X-ray

    • Syndrome of twins's disease treatments

    Hicolytic blood transfusion syndrome is a dangerous complication and needs to be diagnosed early, closely monitored by ultrasound to promptly intervene.

    The mother will rest much during pregnancy, and supplement nutrients, supplements and essential vitamins.

    Although the treatment of blood transfusion syndrome is complicated, but thanks to the progress of medicine, there are many measures to treat twins blood transfusion syndrome such as:

  • Use indocin for the mother
  • Reduce the volume of amniotic fluid, using amniocentesis to drain excess amount, help improve blood flow in the placenta and moreover reduces the risk of premature birth . This method can help save about 60% of children affected
  • Selective pregnancy surgery
  • Blood transfusion for pregnancy in the uterus
  • Open between the two amniotic chambers
  • Cancel an umbilical cord or laser cutting

    • However

  • Suctions to reduce the volume of amniotic fluid often have to be repeated many times and will lead to the risk of high infection, the pregnancy retention time will not be long.
  • The cancellation of an umbilical cord when the fetus is abnormal or if there is a risk of high sequelae
  • The current method of opening amniotic fluid is not applied due to the risk of amniotic fluid ligaments

    • Twin blood transfusion syndrome is an obstetric emergency that needs timely treatment. Depending on the case to have different treatments, depends on the severity of the TTTS and the health status of both parents and children. The goal of treatment is still to help pregnant women safely and healthy until both fetuses can be born safely. However, laser surgery treatment when in stage II - IV Quintero age 16 - 26 weeks is considered the optimal method in the treatment of twins blood transfusion syndrome

    After surgery must be closely monitored to avoid complications for mother and pregnancy

    This is an invasive surgery, so PTV needs to be trained carefully and must have an ultrasonic diagnostic experience.

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