M. Vagaská, A. Bašková, K. Biháriová, D. Micenková, M. Vodecký, J. Višňovský
The incidence of multiple pregnancy is rising, mainly due to advanced maternal age
and widespread use of assisted reproduction techniques. Twin pregnancy is associated
with a high risk of perinatal mortality and morbidity, which is higher in monochorionic
twins comparing with dichorionic ones. Presence of vascular anastomoses
in monochorionic placentas are responsible of specific complications such as the twin
to twin transfusion syndrome. Its incidence is 15-20 % of monochorionic-diamniotic
pregnancies, generally 4 % of all twins. We report the 4th grade of TTTS with hydrops
of one of twins, which was diagnosed early in the 15th week of pregnancy. According
to the risk of demise, the foetoscopic laser coagulation was realized in the 17th week
despite the high risk of premature rupture of membranes. By foetoscopic laser surgery
and subsequent management, we could successfully end the pregnancy in the
34th week by caesarean section with the survival of both twins.