Eco-doppler y su relevancia en el manejo de la restricción del crecimiento intrauterino selectivo en embarazos gemelares monocoriales

Abstract

Introduction: Selective intrauterine growth restriction (sFGR) is defined as a >25% weight discrepancy between one fetus and another in a twin pregnancy, and the smaller twin has an estimated fetal weight below the 10th percentile of normal weight according to at gestational age and is classified as sFGR I, II, and III. Objective: To characterize, through a literature review, the relevance of Doppler echocardiography in the management of selective intrauterine growth restriction in monochorionic twin pregnancies. Materials and methods: Descriptive, retrospective study obtained in databases such as: PubMed, Scielo, Google Scholar, ResearchGate and Cochrane, from the last 5 years and that contribute to the proposed theme. Results: 24 studies were included, of which 21 belong to journals postulated in the first quartile of scientific evidence, where the relevance of echo Doppler in the management of monochorionic twin intrauterine growth restriction in the first health level was analyzed. Conclusions: sFGR in monochorionic twin pregnancies is a complication that occurs in our setting in up to 8.2% of all twin pregnancies; sFGR type I in America, Europe and Asia is managed expectantly in most cases; in sFGR types II and III, fetoscopic laser ablation (FLA) is used with a survival of the fetus with sFGR of 44% and in the more developed fetus 90%; surviving fetuses without neurological damage following AFL ranges from 74% to 90% of cases.