Journal
JOURNAL OF CLINICAL MEDICINE
Volume 11, Issue 23, Pages -Publisher
MDPI
DOI: 10.3390/jcm11237054
Keywords
monochorionic; placenta; thrombophilia; TTTS; twins
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The frequency of inherited thrombophilia is higher in monochorionic twin pregnancies with TTTS, with an increased risk for Factor I and Factor V Leiden allele polymorphism. Maternal inherited thrombophilia may result in impaired development of placental vascular architecture.
Background: To study the frequency of inherited thrombophilia in monochorionic twin pregnancies with twin-twin transfusion syndrome (TTTS). Methods: At the Department of Obstetrics of the Polytechnic University of Marche (Ancona, Italy) a population of monochorionic diamniotic pregnant women was selected retrospectively. After termination of the pregnancy, genotyping for Factor I, Factor V Leiden, Factor II and Methylenetetrahydrofolate Reductase (MTHFR), as well as activities of the plasma proteins C and S, was performed. Results: Regarding the 32 patients with TTTS, from a cohort of 104 monochorionic pregnancies recruited, at least one thrombophilic defect was more frequent (OR: 3.24), and the allele polymorphism frequency was higher for Factor I (OR: 4.4) and for Factor V Leiden (OR: 11.66). Conclusions: Maternal inherited thrombophilia, possibly also inherited from monochorial fetuses, may result in impaired development of the placental vascular architecture. This inheritance hypothesis may explain why only a fraction of monochorionic diamniotic twins develop TTTS.
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