Selective Fetal Growth Restriction Syndrome: Links of Pathogenesis

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.