vestommВестник охраны материнства и младенчестваBulletin of maternal and child care3034-395XФГБУ «НИИ ОММ» Минздрава России10.69964/BMCC-2025-2-3-24-37vestomm-70Research ArticleОБЗОРЫREVIEWSСиндром обратной артериальной перфузии: дискуссионные вопросы тактики ведения (обзор литературы и клиническое наблюдение)Twin reversed arterial perfusion syndrome: controversial issues of management tactics (literature review and clinical observation)https://orcid.org/0000-0002-9362-0852ПановА. Е.PanovA. E.

Панов Антон Евгеньевич - к.м.н., заведующий отделением ультразвуковой диагностики; врач отделения ультразвуковой диагностики

101000, г. Москва, ул. Покровка, д. 22а

129327, г. Москва, ул. Ленская, д. 15

Телефон: +7 (926) 945-03-58

Anton E. Panov - candidate of Medical Sciences, Head of the Ultrasound Diagnostics Department; Physician of the Ultrasound Diagnostics Department

22a Pokrovka str., Moscow, 101000

15 Lenskaya str., Moscow, 129327

Тel: +7 (926) 945-03-58

drpanov82@gmail.comhttps://orcid.org/0000-0003-2305-4493КоцубаД. Р.KotsubaD. R.

Коцуба Даниил Романович - врач отделения ультразвуковой диагностики

101000, г. Москва, ул. Покровка, д. 22а

Телефон: +7 (909) 698-24-12

Daniil R. Kotsuba - ultrasound doctor of the Department of Ultrasound Diagnostics

22a Pokrovka str., Moscow, 101000

Tel: +7 (909) 698-24-12

sir.kotsuba@yandex.ruhttps://orcid.org/0000-0001-6140-1930ЯрыгинаТ. А.YaryginaT. A.

Ярыгина Тамара Александровна - к.м.н., руководитель отделения ультразвуковой диагностики; доцент кафедры ультразвуковой диагностики факультета непрерывного медицинского образования Медицинского Института; научный сотрудник Перинатального кардиологического центра

101000, г. Москва, ул. Покровка, д. 22а

117198, г. Москва, ул. Миклухо-Маклая, 6

121552, Москва, Рублевское шоссе, д. 135

Телефон: +7 (903) 004-81-22

Tamara A. Yarygina - candidate of Medical Sciences, Head of the Ultrasound Diagnostics Department; Associate Professor of the Ultrasound Diagnostics Department, Faculty of Continuous Medical Education; Researcher at the Perinatal Cardiology Center

22a Pokrovka str., Moscow, 101000

117198, Moscow, Miklukho-Maklaya str., 6

135 Rublevskoe Shosse, Moscow, 121552

Tel: +7 (903) 004-81-22

tamarayarygina@gmail.comГосударственное бюджетное учреждение здравоохранения Московской области «Московский областной научно-исследовательский институт акушерства и гинекологии им. академика В.И. Краснопольского» Министерства Здравоохранения Московской области; Государственное бюджетное учреждение здравоохранения города Москвы «Городская клиническая больница имени А.К. Ерамишанцева Департамента здравоохранения города Москвы»РоссияGovernment Budgetary Healthcare Institution of the Moscow region “Moscow Regional Scientific Research Institute of Obstetrics and Gynecology named after Academician V.I. Krasnopolsky” of the Ministry of Health of the Moscow Region; Moscow State Budgetary Healthcare Institution “A.K. Yeramishantsev City Clinical Hospital of the Moscow Department of Health”Russian FederationГосударственное бюджетное учреждение здравоохранения Московской области «Московский областной научно-исследовательский институт акушерства и гинекологии им. академика В.И. Краснопольского» Министерства Здравоохранения Московской областиРоссияGovernment Budgetary Healthcare Institution of the Moscow region “Moscow Regional Scientific Research Institute of Obstetrics and Gynecology named after Academician V.I. Krasnopolsky” of the Ministry of Health of the Moscow RegionRussian FederationГосударственное бюджетное учреждение здравоохранения Московской области «Московский областной научно-исследовательский институт акушерства и гинекологии им. академика В.И. Краснопольского» Министерства Здравоохранения Московской области; Государственное бюджетное учреждение здравоохранения города Москвы «Городская клиническая больница имени А.К. Ерамишанцева Департамента здравоохранения города Москвы»; Российский университет дружбы народов им. Патриса ЛумумбыРоссияGovernment Budgetary Healthcare Institution of the Moscow region “Moscow Regional Scientific Research Institute of Obstetrics and Gynecology named after Academician V.I. Krasnopolsky” of the Ministry of Health of the Moscow Region; Peoples’ Friendship University of Russia. Patrice Lumumba; National Medical Research Center for Cardiovascular Surgery named after A.N. Bakulev, Ministry of Health of the Russian FederationRussian Federation202503072025232437Copyright © Панов А.Е., Коцуба Д.Р., Ярыгина Т.А., 20252025Панов А.Е., Коцуба Д.Р., Ярыгина Т.А.Panov A.E., Kotsuba D.R., Yarygina T.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnikomm.ru/jour/article/view/70

Цель. Провести обзор современной литературы и осветить современный подход к диагностике и лечению синдрома обратной артериальной перфузии (СОАП).Материалы и методы. Для исследования использован обзор литературы из баз данных Medline, Scopus, Web of Science, Google Scholar, PubMed, Wiley и Cochrane Library. Проанализирован клинический случай обратной артериальной перфузии.Результаты. Был рассмотрен патогенез синдрома обратной артериальной перфузии, освещены причины и ошибки в постановке диагноза СОАП. Сформированы основные ультразвуковые критерии для динамического наблюдения и оценки прогнозов для здорового плода. Освещены возможные тактики ведения данных пациентов в зависимости от клинической ситуации, а также возможные методы коррекции при прогрессировании СОАП.Заключение. Анализ данных литературы показал, что существуют различные подходы к наблюдению и лечению СОАП, на данный момент есть однозначное мнение что, необходима ранняя диагностика, комплексное наблюдение, и своевременное оперативное лечение при прогрессировании СОАП. Дальнейшее изучение ультразвуковых признаков прогрессирования синдрома обратной артериальной перфузии и разработка четких алгоритмов наблюдения и оперативного лечения позволит улучшить перинатальные исходы для здорового плода (плод-помпа).

Objective. To review the current literature and highlight the modern approach to the diagnosis and treatment of twin reverse arterial perfusion syndrome (TRAP).Materials and methods. The study used a literature review from the Medline, Scopus, Web of Science, Google Scholar, PubMed, Wiley, and Cochrane Library databases. A clinical case of reverse arterial perfusion is analyzed.Results. The pathogenesis of the twin arterial perfusion syndrome was considered, and the causes of the error in the diagnosis of TRAP were highlighted. The basic ultrasound criteria for dynamic monitoring and evaluation of prognoses for a healthy fetus have been formed. Possible management tactics for these patients are highlighted, depending on the clinical situation, as well as possible correction methods for the progression of TRAP.Conclusion. An analysis of the literature data has shown that there are different approaches to the monitoring and treatment of TRAP, at the moment there is an unequivocal opinion that early diagnosis, comprehensive monitoring, and timely surgical treatment with the progression of TRAP are necessary. Further study of ultrasound signs of progression of twin arterial perfusion syndrome and the development of clear algorithms for monitoring and surgical treatment will improve perinatal outcomes for a healthy fetus (fetus-pump).

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The authors declare that there are no conflicts of interest present.