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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

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PATOFIZIOLOGIJA TWIN TO TWIN TRANSFUZION SINDROMA

Nenad Sulovic ,
Nenad Sulovic
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S. Marjanovic ,
S. Marjanovic
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Lj. Sulovic
Lj. Sulovic
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Published: 01.12.2013.

Volume 43, Issue 4 (2014)

pp. 71-77;

https://doi.org/10.5937/pramed1404071s

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

pregnancy,

twins,

zygosity,

chorionicity,

placental disorders,

ultrasound,

twin to twin transfusion syndroma,

fetal cardiac disorders,

associated syndromes

References

1.
Mahony B, Filly R, Callen P. Amnionicity and chorionicity in twin pregnancies: prediction using ultrasound. Radiology. 1985;(1):205–9.
2.
Taylor M, Denbow M, Tanawattanacharoen S, Gannon C, Cox P, Fisk N. Doppler detection of arterio-arterial anastomoses in monochorionic twins: feasibility and clinical application. Human Reproduction. 2000;(7):1632–6.
3.
Denbow M, Welsh A, Taylor M. Twin fetuses: intravascular microbubble US contrast agent administration -early expirience. Radiology. 2000;724–8.
4.
Denbow M, Cox P, Taylor M. Placental angioarchitecture in monochorionic twin pregnancies: relationship to fetal growth, fetofetal transfusion syndrome, and pregnancy outcome. Am J Obstet Gynecol. 2000;417–26.
5.
Sebire N, Talbert D, Fisk N. Twin-to twin transfusion syndrome results from dynamic asymmetrical reduction in placental anastomoses: a hypothesis. Placenta. 2001;383–91.

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