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Обоснование критериев и тактики ранней пренатальной диагностики ффтс при многоплодной беременности
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JUSTIFICATION OF CRITERIA AND TACTICS OF EARLY PRENATAL DIAGNOSIS OF THE FETO-FETAL
TRANSFUSION SYNDROME AT plural PREGNANCY
O. N. Kharkevich, V. L. Semenchuk
Summary
The research objective was to determine the main criteria of early prenatal diagnostics of feto-fetal transfusion
syndrome (FFTS) and the diagnostic tactics of early FFTS at plural pregnancy. We have examined 106 women with plural
pregnancy in the first and second trimesters of pregnancy, including 32 women with FFTS, 36 women with monochorion
twins without FFTS, 38 pregnant women with bichorion twins. In this research, clinical, laboratory, instrumental, histologic
and statistical methods were applied. It has been established that diagnostics of a chorion of the placenta with twins has
to be carried out by ultrasonography in the first trimester withing 12 weeks of the gestation to find out whether «λ-mark»
exists or not. This allows to estimate the possible risk of FFTS development for pregnancy with twins. The main criteria
of early ultrasonic diagnostics of FFTS in the first trimester for pregnancy with twins is absence of «λ-mark», existence of
folds of the amniotic partition, expansion of the cervical space at one of the fetuses, and the coccygeal-parietal size (CPS)
reduction at the other fetus. The reliability of ultrasonic diagnostics of FFTS in the first trimester of pregnancy with twins
can be 100,0% in absence of «λ-mark» and presence of a combination of three signs: expansion of the cervical space by
more than 3 mm at one of the fetus, reduction of CPS by 3 mm and more at the second fetus, and formation of folds of the
amniotic partition. The reliability of diagnostics of FFTS in identifying monochorion twins with only two characteristic signs
(expansion of cervical space, and/or reduction of the CPS, and/or formation of folds of the amniotic partition) makes 68,8%.
Early prenatal diagnostics of FFTS within 12 weeks of the gestation allows to plan and carry out the treatment in due time.

 

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