Selective Fetal Growth Restriction Syndrome: Links of Pathogenesis

E. R. Frolova, K. A. Gladkova, U. N. Tumanova, V. A. Sakalo, A. I. Shchegolev
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Abstract

Monochorionic diamniotic twins have a higher risk of perinatal complications than dichorionic twins and singleton pregnancy fetuses. Selective fetal growth restriction (sFGR) syndrome is one of the complications of multiple pregnancy; its frequency varies from 10 to 25%. Modern ideas about the pathogenesis of sFGR syndrome indicate its multifactorial nature, including disorders of trophoblast invasion, vasculo- and angiogenesis, gestational formation of placenta with a discordant division of intertwin territories and unbalanced blood flow along interfetal anastomoses, oxidative stress, imbalance of growth factors, and changes in the metabolomic profile of the cord blood and placenta tissue. The clarification of risk factors and links of the pathogenesis of sFGR syndrome underlies the determination of diagnostic markers, development of optimal tactics of pregnancy management, and prediction of perinatal outcome.

选择性胎儿生长受限综合征:发病机制的联系
摘要与二绒毛膜双胎和单胎妊娠的胎儿相比,单绒毛膜双胎发生围产期并发症的风险更高。选择性胎儿生长受限(sFGR)综合征是多胎妊娠的并发症之一,其发生率在10%至25%之间。现代观点认为,选择性胎儿生长受限综合征的发病机制是多因素的,包括滋养细胞侵袭、血管和血管生成障碍、妊娠胎盘的形成与脐带间区域的不和谐分割、胎儿间吻合口的血流不平衡、氧化应激、生长因子失衡、脐带血和胎盘组织代谢组学的变化等。厘清 sFGR 综合征的风险因素和发病机理,是确定诊断指标、制定最佳妊娠管理策略和预测围产期结局的基础。
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