A Multiscale Model for the Feto-placental Circulation in Monochorionic Twin Pregnancies☆

Abstract We developed a mathematical model of monochorionic twin pregnancies to simulate both the normal gestation and the Twin-Twin Transfusion Syndrome (TTTS), a disease in which the interplacental anastomose create a flow imbalance, causing one of the twin to receive too much blood and liquids, becoming hypertensive and polyhydramnios (the Recipient) and the other to become hypotensive and oligohydramnios (the Donor). This syndrome, if untreated, leads almost certainly to death one or both twins. We propose a compartment model to simulate the flows between the placenta and the fetuses and the accumulation of the amniotic fluid in the sacs. The aim of our work is to provide a simple but realistic model of the twins-mother system and to stress it by simulating the pathological cases and the related treatments, i.e. aminioreduction (elimination of the excess liquid in the recipient sac), laser therapy (removal of all the anastomoses) and other possible innovative therapies impacting on pressure and flow parameters.