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Aloysius Suryawan
Faculty of Medicine, Maranatha Christian University, Bandung, West Java, Indonesia
Health Professions Medicine & Pharmacology Public Health

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What Should We Know About Twin to Twin Transfusion Syndrome: A Case Report Novinka Iriane; Andrieta Berliana Marzani; Angelica Rosa Septiana Hartono; Chris Monalisa; Cindy Thalia Putri; Jessica Natasya; Kevin Axel; Zarahnaya Putri; Sheila Meriyani; Rizna Tyrani Rumanti; Theresia Monica Rahardjo; Aloysius Suryawan
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (6921.197 KB) | DOI: 10.58376/mcu.v1i1.6

Abstract

Background Twin-to-twin transfusion syndrome (TTTS) is a condition that can occur as a complication of a monochorionic twin pregnancy that may develop at any stage of pregnancy and most cases are diagnosed in the second trimester of pregnancy. The syndrome is a placental vascular anomaly that can affect the two fetoplacental circulations which can result in hypotony, hypovolemia, anemia, and oliguria being developed in the donor, whereas the recipient fetus is at risk of hypertrophy, hypertension, hypervolemia, polycythemia, and polyhydramnios. Case presentation A 32-year-old multigravida woman (Gravida 5 Para 4 Abortion 0) with a gestational age of 26 weeks came to the Obstetrics and Gynecology Clinic of Unggul Karsa Medika Hospital with the results of the first ultrasound at 24 weeks of gestation which revealed monochorionic diamniotic intrauterine twins and anterior placenta with grade I maturity. Twin A Maturity of 23 weeks 2 days with a fetal weight of 578 grams, oligohydramnios, fetal kidney, and bladder are not visible, whereas Twin B Maturity of 26 weeks 6 days with a fetal weight of 1205 grams, polyhydramnios with a single 12 cm deepest pocket and normal fetal kidney with bladder distention. The diagnosis of twin-to-twin transfusion syndrome was made with twin A as donor twins and twin B as recipient twins. Conclusion TTTS can be diagnosed with routine prenatal ultrasound and can be deferred into 4 stages based on ultrasound and doppler results. There are multiple options for management including expectant management, amnioreduction, intentional septostomy, fetoscopic laser photocoagulation, selective reduction, and voluntary pregnancy termination.
Placental Abruption as a Complication of Preeclampsia that Causes Fetal Distress Indra Hapdijaya; Ecclesia Tessalina; Elisabeth Mariska Natasha Herdiana; Janice Natalia; Gede Anggara Setya Dewa Brata; Hendrik Andrianto; Catharine Welanai Jemarut; Livia Devina; Aloysius Suryawan
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (3323.114 KB) | DOI: 10.58376/mcu.v1i1.12

Abstract

Background Placental abruption is a common complication of preeclampsia. It is an obstetric emergency which occurs when the placenta partially or completely separates from the uterine wall. The diagnosis is usually made clinically or objectively. It is relatively rare but put a serious risk for both the fetus and the mother. Case presentation We reported a case of a 32-year-old multigravida patient at 35-36 weeks gestation presented with moderate vaginal bleeding and lower abdominal pain. Her obstetric history included one premature vaginal delivery. Her blood pressure started to rise in the second trimester of pregnancy. The examination revealed that her blood pressure was 190/120 mmHg, she had pitting edema on her extremities and tender uterine fundus. The fetal heart rate was bradycardia at 100 beats per minute. Placental abruption and fetal distress were diagnosed. An emergency cesarean section was performed. Intraoperatively, the uterus showed intramural bleeding and was livid, with the beginning of Couvelaire-uterus. The uterus was left in situ. Conclusion As a conclusion, placental abruption interrupts the vital function of the placentae which leads to fetal hypoxia and even fetal death. It is an obstetric emergency that requires immediate intervention to save the fetus and reduce the risk of complications in the mother.
Co-Authors Andrieta Berliana Marzani Angelica Rosa Septiana Hartono Catharine Welanai Jemarut Chris Monalisa Cindy Thalia Putri Ecclesia Tessalina Elisabeth Mariska Natasha Herdiana Gede Anggara Setya Dewa Brata Hendrik Andrianto Indra Hapdijaya Janice Natalia Jessica Natasya Kevin Axel Livia Devina Novinka Iriane Rizna Tyrani Rumanti Sheila Meriyani Theresia Monica Rahardjo Zarahnaya Putri