Diastolic cardiac pathology and clinical twin-twin transfusion syndrome in monochorionic/diamniotic twins

Anita J. Moon-Grady, Larry Rand, Salvador Guevara, Kristen Gosnell, Hanmin Lee, Vickie A. Feldstein

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: We sought to identify differences in echocardiographic profiles of monochorionic (MC)/diamniotic (DA) pregnancies with early or mild twin-twin transfusion syndrome (TTTS), compared to MC/DA twins affected only by discordant growth or discordant fluid. Study Design: This was a retrospective evaluation of sonograms and echocardiograms of twin pregnancies referred for suspected TTTS. Results: A total of 112 MC/DA pairs were studied. In all, 41 did not have/develop TTTS, and 61 had stage I/II TTTS. Ten developed TTTS after initially not meeting criteria. TTTS recipients had a higher rate of venous Doppler or tricuspid inflow abnormalities than purported recipients in non-TTTS pregnancies (86% vs 37%, P <.001). TTTS recipients had shorter tricuspid inflow duration/R-R intervals than non-TTTS fetuses (32 ± 6% vs 37 ± 4%, P <.001). Logistic regression and recursive partitioning identified shorter tricuspid inflow duration, longer isovolumic relaxation, and ductus venosus abnormality associated with TTTS. Conclusion: Diastolic pathology, specifically shorter tricuspid inflow duration, may be considered a hallmark of TTTS distinguishing these pregnancies from other MC/DA twin complications.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume205
Issue number3
DOIs
StatePublished - Sep 1 2011
Externally publishedYes

Fingerprint

Fetofetal Transfusion
Clinical Pathology
Pregnancy
Twin Pregnancy
Fetus

Keywords

  • fetal echocardiography
  • monochorionic twins
  • twin-twin transfusion syndrome

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Diastolic cardiac pathology and clinical twin-twin transfusion syndrome in monochorionic/diamniotic twins. / Moon-Grady, Anita J.; Rand, Larry; Guevara, Salvador; Gosnell, Kristen; Lee, Hanmin; Feldstein, Vickie A.

In: American Journal of Obstetrics and Gynecology, Vol. 205, No. 3, 01.09.2011.

Research output: Contribution to journalArticle

Moon-Grady, Anita J. ; Rand, Larry ; Guevara, Salvador ; Gosnell, Kristen ; Lee, Hanmin ; Feldstein, Vickie A. / Diastolic cardiac pathology and clinical twin-twin transfusion syndrome in monochorionic/diamniotic twins. In: American Journal of Obstetrics and Gynecology. 2011 ; Vol. 205, No. 3.
@article{52fe1b42c35d4659a1d9ff845a0f208f,
title = "Diastolic cardiac pathology and clinical twin-twin transfusion syndrome in monochorionic/diamniotic twins",
abstract = "Objective: We sought to identify differences in echocardiographic profiles of monochorionic (MC)/diamniotic (DA) pregnancies with early or mild twin-twin transfusion syndrome (TTTS), compared to MC/DA twins affected only by discordant growth or discordant fluid. Study Design: This was a retrospective evaluation of sonograms and echocardiograms of twin pregnancies referred for suspected TTTS. Results: A total of 112 MC/DA pairs were studied. In all, 41 did not have/develop TTTS, and 61 had stage I/II TTTS. Ten developed TTTS after initially not meeting criteria. TTTS recipients had a higher rate of venous Doppler or tricuspid inflow abnormalities than purported recipients in non-TTTS pregnancies (86{\%} vs 37{\%}, P <.001). TTTS recipients had shorter tricuspid inflow duration/R-R intervals than non-TTTS fetuses (32 ± 6{\%} vs 37 ± 4{\%}, P <.001). Logistic regression and recursive partitioning identified shorter tricuspid inflow duration, longer isovolumic relaxation, and ductus venosus abnormality associated with TTTS. Conclusion: Diastolic pathology, specifically shorter tricuspid inflow duration, may be considered a hallmark of TTTS distinguishing these pregnancies from other MC/DA twin complications.",
keywords = "fetal echocardiography, monochorionic twins, twin-twin transfusion syndrome",
author = "Moon-Grady, {Anita J.} and Larry Rand and Salvador Guevara and Kristen Gosnell and Hanmin Lee and Feldstein, {Vickie A.}",
year = "2011",
month = "9",
day = "1",
doi = "10.1016/j.ajog.2011.06.045",
language = "English (US)",
volume = "205",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Diastolic cardiac pathology and clinical twin-twin transfusion syndrome in monochorionic/diamniotic twins

AU - Moon-Grady, Anita J.

AU - Rand, Larry

AU - Guevara, Salvador

AU - Gosnell, Kristen

AU - Lee, Hanmin

AU - Feldstein, Vickie A.

PY - 2011/9/1

Y1 - 2011/9/1

N2 - Objective: We sought to identify differences in echocardiographic profiles of monochorionic (MC)/diamniotic (DA) pregnancies with early or mild twin-twin transfusion syndrome (TTTS), compared to MC/DA twins affected only by discordant growth or discordant fluid. Study Design: This was a retrospective evaluation of sonograms and echocardiograms of twin pregnancies referred for suspected TTTS. Results: A total of 112 MC/DA pairs were studied. In all, 41 did not have/develop TTTS, and 61 had stage I/II TTTS. Ten developed TTTS after initially not meeting criteria. TTTS recipients had a higher rate of venous Doppler or tricuspid inflow abnormalities than purported recipients in non-TTTS pregnancies (86% vs 37%, P <.001). TTTS recipients had shorter tricuspid inflow duration/R-R intervals than non-TTTS fetuses (32 ± 6% vs 37 ± 4%, P <.001). Logistic regression and recursive partitioning identified shorter tricuspid inflow duration, longer isovolumic relaxation, and ductus venosus abnormality associated with TTTS. Conclusion: Diastolic pathology, specifically shorter tricuspid inflow duration, may be considered a hallmark of TTTS distinguishing these pregnancies from other MC/DA twin complications.

AB - Objective: We sought to identify differences in echocardiographic profiles of monochorionic (MC)/diamniotic (DA) pregnancies with early or mild twin-twin transfusion syndrome (TTTS), compared to MC/DA twins affected only by discordant growth or discordant fluid. Study Design: This was a retrospective evaluation of sonograms and echocardiograms of twin pregnancies referred for suspected TTTS. Results: A total of 112 MC/DA pairs were studied. In all, 41 did not have/develop TTTS, and 61 had stage I/II TTTS. Ten developed TTTS after initially not meeting criteria. TTTS recipients had a higher rate of venous Doppler or tricuspid inflow abnormalities than purported recipients in non-TTTS pregnancies (86% vs 37%, P <.001). TTTS recipients had shorter tricuspid inflow duration/R-R intervals than non-TTTS fetuses (32 ± 6% vs 37 ± 4%, P <.001). Logistic regression and recursive partitioning identified shorter tricuspid inflow duration, longer isovolumic relaxation, and ductus venosus abnormality associated with TTTS. Conclusion: Diastolic pathology, specifically shorter tricuspid inflow duration, may be considered a hallmark of TTTS distinguishing these pregnancies from other MC/DA twin complications.

KW - fetal echocardiography

KW - monochorionic twins

KW - twin-twin transfusion syndrome

UR - http://www.scopus.com/inward/record.url?scp=80052209761&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052209761&partnerID=8YFLogxK

U2 - 10.1016/j.ajog.2011.06.045

DO - 10.1016/j.ajog.2011.06.045

M3 - Article

AN - SCOPUS:80052209761

VL - 205

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 3

ER -