Maternal Inherited Thrombophilia in Monochorionic Twin Pregnancy with Twin-Twin Transfusion Syndrome

Stefano R Giannubilo; Alessia Fiorelli; Daniela Marzioni; Giovanni Tossetta; Giulia Capogrosso; Andrea Ciavattini

doi:10.3390/jcm11237054

Maternal Inherited Thrombophilia in Monochorionic Twin Pregnancy with Twin-Twin Transfusion Syndrome

J Clin Med. 2022 Nov 29;11(23):7054. doi: 10.3390/jcm11237054.

Authors

Stefano R Giannubilo¹, Alessia Fiorelli¹, Daniela Marzioni², Giovanni Tossetta², Giulia Capogrosso¹, Andrea Ciavattini¹

Affiliations

¹ Department of Clinical Sciences, Polytechnic University of Marche, Salesi Hospital, Via Corridoni 11, 60123 Ancona, Italy.
² Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Via Tronto, 10/a, 60126 Ancona, Italy.

Abstract

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.

Keywords: TTTS; monochorionic; placenta; thrombophilia; twins.

Grants and funding

This research received no external funding.