More articles from Volume 43, Issue 4, 2014
OBIM DIFUZNOG OŠTEĆENJA NEURONSKIH I NENEURONSKIH STRUKTURA U KORELACIJI SA KOGNITIVNOM DISFUNKCIJOM
PREDIKTORI POBOLJŠANJA KVALITETA ŽIVOTA ŠEST MESECI NAKON HIRURŠKE REVASKULARIZACIJE MIOKARDA
LASEROTERAPIJA BOLA KOD AKUTNOG CERVIKALNOG SINDROMA
LOŠE ŽIVOTNE NAVIKE -FAKTORI RIZIKA ZA NASTANAK OSTEOPOROZE
Clinical, diagnostic and therapeutic aspects of pulmonary embolism
PATOFIZIOLOGIJA TWIN TO TWIN TRANSFUZION SINDROMA
,
Nenad Sulovic
,
S. Marjanovic
Lj. Sulovic
Abstract
Twin to twin transfusion sindrom (TTTTS) je patološko stanje gde blizanac donor „krvari“ u cirkulaciju fetusa recipijenta preko abnormalnih interblizanačkim placentnih anastomoza. Blizanac donor postaje anemičan, hipovolemičan, zaostaje u rastu i kao posledicu ima smanjenu urinarnu produkciju. Kako funkcija gutanja amnionske tečnosti nije oštećena, volumen plodove vode se progresivno smanjuje. Blizanac recipijent postaje hipervolemičan i policitemičan. Višak cirkulišuće krvi i nemogućnost adekvatne eliminacije nekada može da dovede do pojave hidropsa u težim slučajevima. Povećana urinarna produkcija recipijenta vodi pojavi polihidroamniona i prekomernoj distenziji amnionskog kavuma, kompresije i smanjnje perfuzije donora. Redukcija amnionske tečnosti kod donora rezultuje fiksacijom donora uz zid uterusa (najčešće prednji zid), (Slika 1.) (stanje nazvano stuck twin) 1,36.
Keywords
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