Twin-to-twin transfusion syndrome: New perspectives

Abstract

Twin-to-twin transfusion syndrome is a complication of monochorionic twin gestations associated with high perinatal mortality and morbidity rates. Since the characterization of the syndrome by Herlitz in 1941, 1 Herlitz G. Zur Kenntnis der anämischen undpolyzytischen Zustñde bei Neugeborenen sowie des Icterus gravis neonatorum. Acta Paediatr. 1941; 29: 211-241 Crossref Scopus (10) Google Scholar the clinical findings of TTS have been thoroughly described but the pathogenesis remains unexplained. During the past 5 years substantial progress has been made in the understanding of the pathogenesis and new, more aggressive management of this syndrome has led to increased survival rates. This review analyzes the alternative pathophysiologic mechanisms that challenge the traditional transfusion theory, and sums up the latest developments in diagnosis and therapy.