Fetofetal Transfusion Syndrome: A Comprehensive Look at the Disease

Abstract

Introduction: Fetofetal transfusion syndrome is a complex disease produced in about 15% of monochorionic pregnancies, despite its low incidence, its importance lies in its serious perinatal complications. Its pathophysiology is based on the process in which twins share the two circulations through abnormal blood vessels, with a subsequent hemodynamic alteration of the receptor twin and donor twin. Its diagnosis is primarily with an ultrasound scan and its current definitive treatment consists in-utero strategies performed in order to locate and seal the vessel, providing a single movement, seeking to counteract its poor prognosis, which can lead to a mortality rate of up to 100% in those patients without treatment. Objective: To review the literature about fetofetal transfusion syndrome, covering an update about various components including epidemiology, pathophysiology, clinical advances in its clinical diagnosis and treatment. Methodology: A search was conducted in databases such as PubMed, Cochrane, Sciencedirect and Google scholar and 78 articles were found, but only 32 of them finally achieved the criteria for updating, relevance and quality; also the pathophysiology, diagnosis and treatment were revised in each one. The articles that did not fulfill the inclusion criteria were discarded. Outcomes: The most updated and comprehensive information found in databases was selected according to its classification, etiology, pathophysiology, diagnosis, treatment and prognosis. Conclusions: Fetofetal transfusion Syndrome is a hemodynamic imbalance of placental anastomosis, increased levels of vasopressin and finally, changes in the renin angiotensin aldosterone axis, which requires an early diagnosis and treatment to improve the prognosis and prevent fetal complications. [Durán-Morales MA, Ariza-Parra EJ. Fetofetal Transfusion Syndrome: A Comprehensive Look at the Disease. MedUNAB 2016; 18(3): 204-212].