TWIN TO TWIN TRANSFUSION SYNDROME – DIFFERENTIAL DIAGNOSTICS. CLINICAL CASES

The aim of the study. The study of differential peculiarities of echographic monitoring and perinatal results with specific complications in the monochorionic type of placentation.Materials and methods. Consideration of three clinical observations of pregnancy with monochorionic diamniotic twins that had various complications. The features of the ultrasound assessment in each of the observations, which helped to determine the correct diagnosis and choose the best tactics of pregnancy follow-up, were discussed.Results. In clinical cases examined and analysed, three different complications of monochorionic multiple pregnancy with similar diagnostic features were revealed. Such specific complications of monochorionic multiple pregnancy as TTTS, TRAP and TAPS may demonstrate some similarity in echographic manifestations during prenatal ultrasound assessment, but have different perinatal prognosis and require non-similar tactics.Conclusion. Antenatal monitoring, which includes ultrasound fetal biometry, evaluation of amniotic fluid volumes, Doppler velocimetry aspects, assessment of size of twin’s hearts and bladders, and the features of their umbilical cord and middle cerebral artery blood flow, allows to estimate and predict in some cases the level of perinatal risk in monochorionic multiple pregnancy and select the appropriate clinical management.