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master's thesis
Sindrom feto-fetalne transfuzije
Rijeka: University of Rijeka, Faculty of Medicine, 2022. urn:nbn:hr:184:722823
Bublić, Lucija
University of Rijeka
Faculty of Medicine
Department of Gynaecology and Obstetrics

Institutional repository: Repository of the University of Rijeka, Faculty of Medicine

Cite this document

Bublić, L. (2022). Sindrom feto-fetalne transfuzije (Master's thesis). Rijeka: University of Rijeka, Faculty of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:184:722823

Bublić, Lucija. "Sindrom feto-fetalne transfuzije." Master's thesis, University of Rijeka, Faculty of Medicine, 2022. https://urn.nsk.hr/urn:nbn:hr:184:722823

Bublić, Lucija. "Sindrom feto-fetalne transfuzije." Master's thesis, University of Rijeka, Faculty of Medicine, 2022. https://urn.nsk.hr/urn:nbn:hr:184:722823

Bublić, L. (2022). 'Sindrom feto-fetalne transfuzije', Master's thesis, University of Rijeka, Faculty of Medicine, accessed 26 December 2024, https://urn.nsk.hr/urn:nbn:hr:184:722823

Bublić L. Sindrom feto-fetalne transfuzije [Master's thesis]. Rijeka: University of Rijeka, Faculty of Medicine; 2022 [cited 2024 December 26] Available at: https://urn.nsk.hr/urn:nbn:hr:184:722823

L. Bublić, "Sindrom feto-fetalne transfuzije", Master's thesis, University of Rijeka, Faculty of Medicine, Rijeka, 2022. Available at: https://urn.nsk.hr/urn:nbn:hr:184:722823

Metadata
TitleSindrom feto-fetalne transfuzije
Title (english)Twin to twin transfusion syndrome
AuthorLucija Bublić
MentorAleks Finderle (mentor)
Committee memberTea Štimac (predsjednik povjerenstva)
GranterUniversity of Rijeka
Faculty of Medicine
(Department of Gynaecology and Obstetrics)
Rijeka
Defense date and country2022-07-15, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Gynecology and Obstetrics
Abstract
Sindrom feto-fetalne transfuzije (TTTS) česta je komplikacija monokorionskih blizanačkih trudnoća zbog prijenosa volumena i hormonski aktivnih tvari s jednog blizanca na drugog preko krvožilnih anastomoza posteljice. Bez prepoznavanja i liječenja, uznapredovali TTTS značajno doprinosi smrti fetusa. Ultrazvučna dijagnoza monokorionske placente najpouzdanija je u prvom tromjesečju i određuje intenzitet praćenja trudnoće. Dijagnoza TTTS-a postavlja se ne temelju ultrazvučnog nalaza koji govori u prilog polihidramnija jednog blizanca i oligohidramnija drugog blizanca. Procjena punjenja mokraćnog mjehura, kao i Doppler mjerenja protoka pupčane arterije i vene, potrebni su za utvrđivanje stadija bolesti. Procjena fetalne srčane funkcije pruža dodatni uvid u ozbiljnost stanja fetusa, ali i pomaže izdvojiti fetuse kojima bi mogla biti potrebna postnatalna skrb i liječenje. Fetoskopska laserska fotokoagulacija krvožilnih anastomoza posteljice standardni je tretman za TTTS. Cilj je prekinuti vezu između blizanačkih cirkulacija kako bi se uklonila neravnoteža intravaskularnog volumena. Međutim, prijevremeni porođaj, usprkos liječenju, i dalje značajno doprinosi postnatalnom morbiditetu i mortalitetu. Dugoročni ishodi pokazuju da djeca nakon liječenja fetoskopskom laserskom fotokoagulacijom mogu pokazivati znakove neurološkog oštećenja. Strategije za smanjenje broja prijevremenog porođaja nakon liječenja i standardizirani izvještaji referentnih centara za fetoskopsku lasersku kirurgiju važni su za poboljšanje ukupnih ishoda i razumijevanje dugoročnih učinaka TTTS-a.
Abstract (english)
Twin to twin transfusion syndrome (TTTS) is common complication of monochorionic twin pregnancies due to the transfer of volume and hormonally active substances from one twin to another via vascular anastomoses on the placenta. Without recognition and treatment, TTTS has significant contribution to fetal death. Ultrasound diagnosis of monochorionic placenta is the most reliable in the first trimester and determines the intensity of pregnancy monitoring. The diagnosis of TTTS is based on an ultrasound findings of polyhydramnios of one twin and oligohydramnios of the other twin. Assessment of bladder filling, as well as Doppler measurements of umbilical artery and vein flow, are needed to determine the stage of the disease. Assessment of fetal cardiac function provides additional insight into the severity of the fetal condition, but also helps to isolate fetuses that may need postnatal care. Fetoscopic laser ablation of vascular anastomoses between twins is the standard treatment for TTTS. The goal is to break the connection between the twin circulations in order to eliminate the imbalance of vascular volume. Despite the treatment, preterm birth still contributes to postnatal morbidity and mortality. Long-term outcomes indicate that children may show signs of neurological damage after treatment. Strategies of reducing preterm delivery after treatment and standardized reports from reference centers for fetoscopic laser surgery are important to improve overall outcomes and understand the long-term effects of TTTS.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:184:722823
Study programmeTitle: Medicine
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2022-06-25 20:22:47