Twin to Twin

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Twin to Twin Transfusion SyndromeAugust, 26th 2014Supervisor:dr. Agus Thoriq, SpOG

DM Jaga:Santi, Ria, Ayu, YuliObjectiveKehamilan kembarAnastomosis vaskularTwin to twin transfusion syndromeT3 STwin PregnanciesDizigotikMonozigotikDiamniotik/dikorionikDiamniotik/monokorionikMonoamniotik/monokorionikKembar siamT3 S

Anastomosis VaskularUmumnya kembar plasenta monokorion ~ 100%Arteri arteri ~75%Vena vena ~50%Arteri vena ~50%

Third circulation twin to twintransfusion syndrome

T3 S

Twin to Twin Transfusion SyndromeDarah ditransfusikanDonor anemis ~~ plasentaResepien polisitemia

T3 S

PatofisiologiAnastomosisSuperfisial aliran lebih seimbang menghambat T3SDalam aliran lebih keras T3STergantung tekanan darah arteri pada fetus donorKerusakan otakDonor iskemia, hipotensiResepien multikistik, hipertensiT3 SDiagnosisPerbedaan Hb 5 mg/dlUSGPolihidramnion >< oligohidramnion

T3 SDiscordant TwinBayi kembar yang bertentanganPenyebab pasti belum diketahui hipotesa sementara akibat anastomosis plasenta

.. Thank You ..


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