SÍNDROME DE TRANSFUSÃO FETO-FETAL (STFF) OU SÍNDROME DE TRANSFUSÃO GÊMELO GEMELAR (STGG): REVISÃO DE LITERATURA

ABSTRACT Feto-fetal transfusion syndrome involves monozygotic and monochorionic twins, especially diamniotic twins, involving a donor fetus and another recipient, whose circulations end up communicating in the placental region. This syndrome affects around 15% of monochorionic twin pregnancies in the second trimester and, if not treated when it occurs before the 24th week, is associated with the death of one or both fetuses in 80% to 90% of the cases. For this reason, it must be screened in all monochorionic pregnancies. The objective of this study is to carry out a literature review based on a bibliographic survey about the main epidemiological, clinical and therapeutic aspects of TTTS. The Lillacs database was consulted, as the search terms used were “fetal-fetal transfusion syndrome”, “TTTS”, “diagnosis” and “treatment”. eighty-five literature review and/or systematic review articles were obtained, leaving only twenty selected after applying the eligibility criteria. Regarding pathophysiology, monochorionic placental vascular communications exist in practically all pregnancies, but only certain patterns lead to TTTS. TTTS appears to result from the presence of one or more arteriovenous communications in combination with a paucity of arterioarterial anastomoses. These arterioarterial communications are found abundantly in uncomplicated monochorionic pregnancies and probably compensate for the hemodynamic imbalance resulting from the arteriovenous shunt. The diagnosis is simple, however, it is exclusively via ultrasound and must be made as early as possible, highlighting the importance of detecting chorionicity in twin pregnancy, in addition to serial ultrasound monitoring to track the development of TTTS. Although there is still no established standardized treatment protocol, laser ablation of placental vessels is the most used technique for treatment. Presenting a high survival rate of one of the fetuses and low rates of neonatal neurological sequelae, it must be performed between the 16th and 26th week of pregnancy. Keywords: Monozygotic and Diaminiotic Monochorionic Twinning; Placental Circulation; Feto-Fetal Transfusion.