There are certain things in life that we never hear about or imagine what it is about, until we get through the situation. This is the case of fetal fetus transfusion, which is a complication that occurs in twin or multiple pregnancies and ends up causing a lot of concern to parents when they encounter it.
Fetal fetal transfusion syndrome as it is called by doctors is a complication caused by the division of the same placenta by two babies during pregnancy , but separated into different amniotic bags. The fact is also known as diaminiotic and monochorionic pregnancy, which is when it has a single placenta to feed and nourish the two babies. The big problem is caused by the imbalance of blood flow that must divide and pass the blood to the two babies and is not always able to do the “job” correctly, which ends up resulting in babies of totally disproportionate sizes.
The passage of blood flow occurs through connections of veins and placental arteries that will be connected to the two babies and this imbalance will make one of the babies the blood donor and the other the recipient , who will be the biggest and best baby to develop.
How to Diagnose and Is There Treatment?
Through the ultrasound exam it is possible to analyze the amount of amniotic fluid in the two bags, which in these cases is found in one increased and the other reduced. This picture is named as polydramnia which is the amount of liquid above the expected and oligodramnia which is the reduced value. The bag where the above-normal fluid is found is where the largest baby, also called the recipient, is found. In the bag with the least amount of liquid is the smallest and least developed baby also named donor.
Another fact observed during the ultrasound exam is in relation to the babies’ urinary bladder. The larger baby has a larger bladder with a large amount of fluid, unlike the smaller baby that has an almost imperceptible bladder because it does not contain any liquid inside. The method of visualizing the amount of amniotic fluid is different from that used in a single pregnancy, as the amount of fluid in the vertical pocket is observed . When the amount of liquid in the pocket measures 8 cm or more, polydramnia is observed and when less than 2 cm is found, oligodramnia.
As for the treatment, two methods are applied to revert the situation, the serial amniodrenage where the excess amniotic fluid is removed from the baby named recipient. The procedure aims to reduce the chances of premature birth of babies and can be performed as many times as necessary to reduce excess fluid. However, it presents risks to the fetus presenting a 15% risk of fetuses presenting cerebral palsy, with 66% success in the results.
And the Fetoscopy where the cauterization of the interconnected vessels and arteries in the fetuses is performed. Where the focus is to interrupt the blood exchange between the twins . It has an 85% chance of success with a 4% risk of developing cerebral palsy in babies. When the fetal fetus transfusion is diagnosed, it is necessary to perform one of the aforementioned techniques, otherwise a 100% risk of fetal death is reported. For more information and adequate treatment, a specialist in Fetal Medicine should be sought and a complete evaluation of the condition will be carried out.
My name is Dr. Alexis Hart I am 38 years old, I am the mother of 3 beautiful children! Different ages, different phases 16 years, 12 years and 7 years. In love with motherhood since always, I found it difficult to make my dreams come true, and also some more after I was already a mother.
Since I imagined myself as a mother, in my thoughts everything seemed to be much easier and simpler than it really was, I expected to get pregnant as soon as I wished, but it wasn’t that simple. The first pregnancy was smooth, but my daughter’s birth was very troubled. Joana was born in 2002 with a weight of 2930kg and 45cm, from a very peaceful cesarean delivery but she had already been born with congenital pneumonia due to a broken bag not treated with antibiotics even before delivery.