Fetal Doppler changes 1 week after endoscopic equatorial laser for twin-to-twin transfusion syndrome: A longitudinal study

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Abstract

Objective: To investigate sequential Doppler changes in donors and recipients before and 1 week after endoscopic laser for twin-to-twin transfusion syndrome (TTTS) and to examine factors that may be associated with such changes. Methods: In TTTS pregnancies undergoing laser treatment, we examined fetal Doppler changes before and 1 week postintervention. Intrauterine death rates and preoperative factors were analyzed in relation to Doppler changes. Results: Among 129 (85.4%) donors surviving at 1 week after laser, there was normalization of umbilical artery flow in 26 (72.2%) of 36 cases with preoperative abnormal Dopplers. In the remaining 10 (27.8%) fetuses, abnormal findings persisted. The rate of later intrauterine death was significantly higher in the latter group (6 of 10, 60.0%) compared with fetuses in which Doppler findings normalized (4 of 26, 15.4%; P < .05), with no difference in the rate of severe donor growth restriction between the 2 groups (80.0% vs 65.4%, respectively; P = .688). Conclusions: In about 70% of TTTS donors with preoperative abnormal umbilical artery Doppler, there was normalization 1 week after endoscopic laser. The incidence of fetal growth restriction was not significantly different in donors with persistence of Doppler abnormalities compared with those with normalized findings.

Original languageEnglish
Pages (from-to)344-348
JournalPrenatal Diagnosis
Volume38
Issue number5
DOIs
Publication statusPublished - 2018

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Fetofetal Transfusion
Longitudinal Studies
Lasers
Umbilical Arteries
Fetus
Fetal Development
Pregnancy
Mortality
Incidence
Growth

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Genetics(clinical)

Cite this

@article{64343457cb234728b09ea6637cb13e62,
title = "Fetal Doppler changes 1 week after endoscopic equatorial laser for twin-to-twin transfusion syndrome: A longitudinal study",
abstract = "Objective: To investigate sequential Doppler changes in donors and recipients before and 1 week after endoscopic laser for twin-to-twin transfusion syndrome (TTTS) and to examine factors that may be associated with such changes. Methods: In TTTS pregnancies undergoing laser treatment, we examined fetal Doppler changes before and 1 week postintervention. Intrauterine death rates and preoperative factors were analyzed in relation to Doppler changes. Results: Among 129 (85.4{\%}) donors surviving at 1 week after laser, there was normalization of umbilical artery flow in 26 (72.2{\%}) of 36 cases with preoperative abnormal Dopplers. In the remaining 10 (27.8{\%}) fetuses, abnormal findings persisted. The rate of later intrauterine death was significantly higher in the latter group (6 of 10, 60.0{\%}) compared with fetuses in which Doppler findings normalized (4 of 26, 15.4{\%}; P < .05), with no difference in the rate of severe donor growth restriction between the 2 groups (80.0{\%} vs 65.4{\%}, respectively; P = .688). Conclusions: In about 70{\%} of TTTS donors with preoperative abnormal umbilical artery Doppler, there was normalization 1 week after endoscopic laser. The incidence of fetal growth restriction was not significantly different in donors with persistence of Doppler abnormalities compared with those with normalized findings.",
author = "Nicola Persico and Francesco D'Ambrosi and Isabella Fabietti and Simona Boito and Elisa Aiello and Alessandro Bulfoni and Fabrizio Ciralli and Alessandra Kustermann and Fabio Mosca and Luigi Fedele",
year = "2018",
doi = "10.1002/pd.5234",
language = "English",
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pages = "344--348",
journal = "Prenatal Diagnosis",
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TY - JOUR

T1 - Fetal Doppler changes 1 week after endoscopic equatorial laser for twin-to-twin transfusion syndrome

T2 - A longitudinal study

AU - Persico, Nicola

AU - D'Ambrosi, Francesco

AU - Fabietti, Isabella

AU - Boito, Simona

AU - Aiello, Elisa

AU - Bulfoni, Alessandro

AU - Ciralli, Fabrizio

AU - Kustermann, Alessandra

AU - Mosca, Fabio

AU - Fedele, Luigi

PY - 2018

Y1 - 2018

N2 - Objective: To investigate sequential Doppler changes in donors and recipients before and 1 week after endoscopic laser for twin-to-twin transfusion syndrome (TTTS) and to examine factors that may be associated with such changes. Methods: In TTTS pregnancies undergoing laser treatment, we examined fetal Doppler changes before and 1 week postintervention. Intrauterine death rates and preoperative factors were analyzed in relation to Doppler changes. Results: Among 129 (85.4%) donors surviving at 1 week after laser, there was normalization of umbilical artery flow in 26 (72.2%) of 36 cases with preoperative abnormal Dopplers. In the remaining 10 (27.8%) fetuses, abnormal findings persisted. The rate of later intrauterine death was significantly higher in the latter group (6 of 10, 60.0%) compared with fetuses in which Doppler findings normalized (4 of 26, 15.4%; P < .05), with no difference in the rate of severe donor growth restriction between the 2 groups (80.0% vs 65.4%, respectively; P = .688). Conclusions: In about 70% of TTTS donors with preoperative abnormal umbilical artery Doppler, there was normalization 1 week after endoscopic laser. The incidence of fetal growth restriction was not significantly different in donors with persistence of Doppler abnormalities compared with those with normalized findings.

AB - Objective: To investigate sequential Doppler changes in donors and recipients before and 1 week after endoscopic laser for twin-to-twin transfusion syndrome (TTTS) and to examine factors that may be associated with such changes. Methods: In TTTS pregnancies undergoing laser treatment, we examined fetal Doppler changes before and 1 week postintervention. Intrauterine death rates and preoperative factors were analyzed in relation to Doppler changes. Results: Among 129 (85.4%) donors surviving at 1 week after laser, there was normalization of umbilical artery flow in 26 (72.2%) of 36 cases with preoperative abnormal Dopplers. In the remaining 10 (27.8%) fetuses, abnormal findings persisted. The rate of later intrauterine death was significantly higher in the latter group (6 of 10, 60.0%) compared with fetuses in which Doppler findings normalized (4 of 26, 15.4%; P < .05), with no difference in the rate of severe donor growth restriction between the 2 groups (80.0% vs 65.4%, respectively; P = .688). Conclusions: In about 70% of TTTS donors with preoperative abnormal umbilical artery Doppler, there was normalization 1 week after endoscopic laser. The incidence of fetal growth restriction was not significantly different in donors with persistence of Doppler abnormalities compared with those with normalized findings.

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