Tara Kizer looks at transactional replication in Azure SQL Database Managed Instances:
I have a love-hate relationship with replication. Mostly hate due to latency and errors, but it does serve its purpose. Before Availability Groups came out, I used Transactional Replication to copy data from the production OLTP database to another server so that we could offload reports.
Will it work with a Managed Instance?
My relationship is closer to hate-hate-love-hate-hate-love-hate. Tara also provides some good advice about watching replication latency stats.