Fetofetal

1980, Angelo Ferrara, Anantham Harin, Emergency transfer of the high-risk neonate: a working manual for medical, nursing, and administrative personnel, C.V. Mosby Fetofetal transfusion is a condition in which one twin (recipient) will be hypervolemic, in cardiac failure, and plethoric, while the donor twin will be hypovolemic, shocky, and pale. Chronic fetofetal transfusions can result in a discrepancy of weight of over 10%.

In four cases, appropriate shunt communications meant that the morpho-anatomical conditions were available for the presence of a fetofetal transfusion syndrome.

The incidence of fetofetal transfusion syndrome was 20%, more than double the incidence previously reported in large series of twin deliveries that encompassed a wider gestational age range. The overall mortality was 55%, and mortality for the fetofetal transfusion group was 70%, whereas a subset of the fetofetal transfusion group, those without weight discordancy, had a mortality rate of 75%.

When fetofetal transfusion syndrome occurs in very preterm gestation, treatment options are limited and often unsuccessful. The perinatal morbidity and mortality of fetofetal transfusion syndrome in very premature twin gestations in 48 pairs of twin gestations delivered at 24-28 weeks' gestation were studied.

As a result of this imbalance, a net fetofetal transfusion occurs, from one twin (the donor) to the other (the recipient).

Acute fetal hypovolemia may be secondary to hemorrhage, as in placenta previa at the end of the pregnancy, or to fetomaternal or fetofetal transfusion. The fetal circulation is theoretically independent, but at the end of pregnancy, fetomaternal or fetofetal circulatory anastomosis may exist.