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 language | English (US) |
|---|---|
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 205 |
| Issue number | 3 |
| DOIs | |
| State | Published - Sep 1 2011 |
| Externally published | Yes |
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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 journal › Article
}
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 -