Dejavniki tveganja za nastanek sindroma transfuzije dvojčka dvojčku : diplomsko delo

Rednak, Ellen (author), Prelec, Anita (mentor), Petročnik, Petra (reviewer)

Uvod: Večplodne nosečnosti, pri katerih se razvijata dva ali več plodov, so zaradi medicinskih postopkov oploditve vse pogostejše. Dvojčki so lahko enojajčni ali dvojajčni, pri čemer enojajčni pogosto delijo posteljico, kar povečuje tveganje za zaplete, kot je sindrom transfuzije dvojčka dvojčku. Ta nastane zaradi neravnovesja v krvnem obtoku med plodoma in zahteva natančno diagnozo ter zdravljenje, kot sta fetoskopska laserska fotoagulacija in amnioredukcija. Večplodne nosečnosti prinašajo tudi večje tveganje za prezgodnji porod in nevrološke poškodbe pri novorojenčkih. Babice imajo ključno vlogo pri spremljanju nosečnosti, prepoznavanju tveganj ter pravočasnem ukrepanju. Zaradi povečanega tveganja zapletov so nujni pogostejši ultrazvočni pregledi in skrbno spremljanje nosečnice in plodov. Namen: Namen diplomskega dela je prepoznati dejavnike tveganja za pojav sindroma transfuzije dvojčka dvojčku v nosečnosti in vlogo babice pri teh nosečnostih. Metode dela: V diplomskem delu je uporabljena deskriptivna ali opisna metoda raziskovanja, ki je temeljila na metodi analize s pomočjo teoretičnega pregleda strokovne in znanstvene literature. Iskalno strategijo smo prikazali s PRISMA diagramom. Rezultati: V pregled literature smo vključili 16 virov. Pomembna je struktura posteljice in njene nepravilnosti, saj pomembno vpliva na razvoj sindroma transfuzije dvojčka dvojčku. Zgodnji napovedovalci vključujejo neskladje med dvojčkoma in druge zaplete, kar zahteva natančno spremljanje nosečnosti dvojčkov že od zgodnje nosečnosti. Natančna ultrazvočna diagnostika je ključna za zgodnje odkrivanje in obvladovanje sindroma transfuzije dvojčka dvojčku, ker se lahko ta v akutni obliki pojavi nenadoma, kar še posebej poudarja potrebo po strogem nadzoru. Razprava in zaključek: Glede na rezultate pregleda literature je sindrom transfuzije dvojčka dvojčku redek, a zelo resen pojav monohorionskih dvojčkov, pri katerih je pomembna zgodnja obravnava in odkritje. Kljub kirurškim metodam zdravljenja ostaja sindrom transfuzije dvojčka dvojčku izziv, zaradi dolgoročnih posledic na dvojčkih. Skrbno spremljanje, pravočasna diagnoza in ustrezno zdravljenje so ključni za izboljšanje izidov pri nosečnostih s tem pojavom.

• Language: Slovenian
• Keywords: diplomska dela, babištvo, sindrom transfuzije dvojčka dvojčku, dvojčki, nosečnost, babica
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [E. Rednak]
• Year: 2025
• Number of pages: 28 str.
• PID: 20.500.12556/RUL-171991
• UDC: 618.2/.7
• COBISS.SI-ID: 247783171
• Publication date in RUL: 05.09.2025

Secondary language

• Language: English
• Title: Risk factors for twin-to-twin transfusion syndrome : diploma work

Abstract

Introduction: Multiple pregnancies, in which two or more fetuses develop, are becoming increasingly common due to medical fertilization procedures. Twins can be either monozygotic or dizygotic. Monozygotic twins often share a placenta, which increases the risk of complications such as twin-to-twin transfusion syndrome. This occurs due to an imbalance in the blood circulation between the fetuses and requires precise diagnosis and treatment, such as fetoscopic laser photocoagulation and amnioreduction. Multiple pregnancies also carry a higher risk of preterm birth and neurological damage in the newborn. Midwives play a key role in monitoring the pregnancy, recognizing risks, and taking timely action. Due to the increased risk of complications, more frequent ultrasound examinations and careful monitoring of both the pregnant woman and the fetuses are necessary. Purpose: The purpose of this diploma work is to identify the risk factors for the occurrence of twin-to-twin transfusion syndrome in pregnancy and the midwife role during these pregnancies. Methods: The diploma work uses a descriptive method of research, based on the analysis of theoretical reviews of professional and scientific literature, supported by the PRISMA diagram. Results: 16 resources were included in literature review. The structure of the placenta and its abnormalities is important, and they are crucial, as they significantly influence the development of twin-to-twin transfusion syndrome. Early predictors include discrepancies between the twins and other complications, requiring careful monitoring of twin pregnancies from early gestation. Accurate ultrasound diagnostics are essential for early detection and management of twin-to-twin transfusion syndrome, as acute can appear suddenly, emphasizing the need for strict monitoring. Discussion and conclusion: According to the results of the literature review, twin-to-twin transfusion syndrome is a rare but very serious condition among monochorionic twins, where early detections and management are crucial. Despite surgical treatment methods, twin-to-twin transfusion system remains a challenge due to its long-term effects on the twins. Careful monitoring, timely diagnosis, and appropriate treatment are key to improving outcomes in pregnancies affected by this.

• Keywords: diploma theses, midwifery, twin-to-twin transfusion syndrome, twins, pregnancy, midwife