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le syndrome transfuseur transfuse : physiopathologie, diagnostic et ...

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[31] Lopriore E <strong>et</strong> al. In utero acquired limb ischemia in monochorionic twins with and without twin-to-twin<br />

transfusion <strong>syndrome</strong>. Prenat Diagn 2008;28:800–4.<br />

[32] Rossi, D’addario. Quintero staging system for twin-twin transfusion <strong>syndrome</strong>. American journal of<br />

perinatology 2009; 26: 537-44<br />

[33] Roberts <strong>et</strong> al. Interventions for twin–twin transfusion <strong>syndrome</strong>: a Cochrane review. Ultrasound<br />

Obst<strong>et</strong> Gynecol 2008; 31: 701–711<br />

Donn<br />

eur<br />

Sang<br />

Hypovolé<br />

mie<br />

Hypoperfusion<br />

réna<strong>le</strong><br />

↗<br />

SRA*<br />

↗<br />

Angiotensine<br />

Vasoconstrict<br />

2<br />

ion Dysgénésie tubulaire<br />

Oligoamnios<br />

Vasoconstriction <strong>et</strong><br />

hypoperfusion<br />

placentaire RCIU<br />

Rece<br />

veur<br />

Hypervolémie +<br />

Hyperviscosité<br />

↗<br />

SRA*<br />

↗ TA<br />

Rrétention<br />

hydrique<br />

Hypertrophie du<br />

VD** <strong>et</strong> VG**<br />

IT / IM***<br />

Cardiomyopathie<br />

hypertrophique<br />

Anasarque fo<strong>et</strong>oplacentaire<br />

Sténose pulmonaire<br />

fonctionnel<strong>le</strong><br />

Schéma 1 : illustrant la <strong>physiopathologie</strong> du <strong>syndrome</strong> <strong><strong>transfuse</strong>ur</strong> transfusé<br />

* : système rénine angiotensine,<br />

**: ventricu<strong>le</strong> droit, ventricu<strong>le</strong> gauche<br />

*** : insuffisance tricuspide, insuffisance mitra<strong>le</strong><br />

9

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