Abstract

RUOTI COSP1, Miguel. Selective intrauterine growth restriction in monochorionic-diamniotic twins: diagnosis and management. Rev. Nac. (Itauguá) [online]. 2016, vol.8, n.1, pp.43-61. ISSN 2072-8174.  https://doi.org/10.18004/rdn2016.0008.01.043-061.

Selective intrauterine growth restriction occurs in 10-19% of monochorionic twins, and is associated with increased mortality important and perinatal morbidity. The clinical course is given largely by the presence of placental vascular anastomosis and asymmetric distribution. It classified into three types according to the proposed Doppler umbilical artery smaller twin, the one that correlates with different clinical behaviors and characteristics of the placenta, which helps in counseling and obstetric conduct. The type I have a favorable prognosis for satisfactory perinatal outcome so closely monitored by ultrasound and Doppler is recommended. The type II has a poor prognosis and type III intermediate and unpredictable prognosis. In these last two you can make an expectant management until deterioration of the small fetus is observed, considering laser coagulation or cord occlusion (selective feticide). Both behaviors appear to increase the chances of survival of the fetus of normal weight.

Keywords : selective intrauterine growth restriction, diagnosis, management monochorionic twins, doppler, fetal therapy.

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