Twin to Twin Transfusion Syndrom

Abstract

Abstrak
Peningkatan mortalitas pada kembar monokorion disebabkan oleh adanya anastomosis vaskuler pada plasenta yang menyebabkan Twin to Twin Transfussion syndrome.Berikut laporan kasus yang ditangani di RS. DR. M. Djamil Padang. Kasus 1: Seorang pasien usia 28 tahun dengan diagnosa MP3 gravid preterm 33-34 minggu dengan Twin To Twin Transfusion Syndrom, Dari pemeriksaan USG didapatkan kesan: Gemelli, gravid 33-34 minggu dengan TTTS. Pasien diterminasi secara SCTPP. Bayi pertama lahir perempuan, dengan: BB: 1400 grams, PB: 44 cm, A / S: 8/9, Bayi ke II: perempuan, BB: 1000 grams, PB: 38 cm, A / S: 6/7, Hb janin I: 16,9 g/dl dan Hb janin II : 11,3 g/dl. Kedua bayi dirawat di bagian perinatology. Bayi pertama bertahan hidup dengan beberapa kelainan kongenital yaitu VSD dan Hemangioma Orbita. Bayi kedua meninggal pada usia 7 hari dengan susp. Sepsis. Hingga saat ini, bayi ini masih kontrol rutin ke poliklinik RS. DR. M. Djamil Padang. Kasus 2: Seorang pasien usia 31 tahun dengan diagnosa MP5 parturient aterm kala II dengan gemelli. Pasien melahirkan spontan. Bayi pertama lahir perempuan dengan: BB: 3200 grams, PB: 48cm, A / S: 8/9, Bayi ke II perempuan : BB: 2100 grams, PB: 44 cm, A / S: 7/8. Kadar Hb bayi I : 17,6 g/dl dan bayi II: 14,1 g/dl. Plasenta lahir secara spontan lengkap 1 buah, berat 1150 gr, ukuran 20x19 x3 cm, panjang kedua tali pusat masing-masing 60 cm, insersi paracentralis,Monokhorion-Monoamnion. Kesan: TTTS.
Kata kunci: twin to twin transfusion sindrom, ultrasonografi, monokorion

Abstract
Increased mortality in monochorionic fetus caused by vascular anastomosis in the placenta that causes Twin to Twin Transfusion Syndromes (TTTS). Reporting two cases experienced and taken care in our hospital. Case1: a woman 28 years old was diagnosed with MP3 preterm pregnancy 33-34 weeks with Twin to Twin Transfusion Syndromes.Ultrasound impression: Gemelli gravid 33-34 weeks with TTTS. The patient was terminated by SCTPP. The first baby was female, born with: BW: 1400 grams, BL: 44 cm, A / S: 8/9, the second baby: female, BW: 1000 grams, BL: 38 cm, A / S: 6/7 the first baby Hemoglobin was 16,9 g/dl and the second baby was 11,3 g/dl. The babies were treated in Perinatology, the first baby survive with some congenital abnormalities such as VSD and hemangioma in the orbita. The second baby died at the age of 7 days with suspected sepsis. To date the baby still has a routine medical checkup to RS. DR. M. Djamil Padang. Case2: a woman 31 years old with diagnose MP5 term parturient in second stage of labour with, gemelli. The babies were born spontaneously. The first baby: BW: 3200 gr, BL: 48 cm, A/S: 8/9. The second baby: BW: 2100 gr, BL: 44 cm, A/S: 7/8. Hemoglobin Concentration of the first baby: 17,6 g/dl and the second baby : 11,4 g/dl. Placenta was born monochorion, diamnion.
Keywords:twin to twin transfusion syndrome, ultrasonography, monochorion