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Sensitive detection of hemodynamic changes after fetoscopic laser photocoagulation by assessing intraventricular pressure difference in fetuses with twin-to-twin transfusion syndrome

  • Shun Masaoka , Yuka Yamamoto EMAIL logo , Mayumi Takano , Sumito Nagasaki , Ken Takahashi , Masahiko Nakata and Atsuo Itakura
Published/Copyright: August 9, 2024
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 52 Issue 8

Abstract

Objectives

To assess the hemodynamics of twin-to-twin transfusion syndrome (TTTS), we measured the intraventricular pressure difference (IVPD), a sensitive marker of myocardial diastolic function, using fetal echocardiography.

Methods

We included 28 monochorionic diamniotic (MD) twins diagnosed with TTTS who underwent fetoscopic laser photocoagulation (FLP) between 2018 and 2022. Color M-mode Doppler images of both cardiac ventricles were obtained before and after FLP. According to this evaluation, the IVPDs were divided into three groups; those with total, basal, and mid-apical IVPD.

Results

Of the 28 twins, 21 were available for analysis (including eight, eight, three, and two cases in stages Quintero Ⅰ, Ⅱ, Ⅲd, and Ⅲr, respectively). Comparing the pre and postFLP results, significant increases in total and mid-apical IVPD in the left ventricle (LV) of recipient twins were noted (total and mid-apical IVPD: p=0.026 and 0.013, respectively). In the LV of the donor twins, all IVPDs were significantly increased after FLP (total, basal, and mid-apical IVPD: p=0.003, 0.001, and 0.022, respectively). In addition, comparisons between the donor and recipient groups did not show significant differences in either ventricle before FLP.

Conclusions

IVPD detected subtle hemodynamics changes, such as volume overload and diastolic dysfunction in TTTS before and after FLP. Therefore, IVPD may be a useful marker for monitoring myocardial diastolic function in TTTS.

Keywords: diastolic function; echocardiography; fetoscopic laser surgery; intraventricular pressure difference; monochorionic twin; twin to twin transfusion syndrome
Corresponding author: Yuka Yamamoto, MD, PhD, Department of Obstetrics and Gynecology, Faculty of Medicine, Juntendo University, 3-1-3 Hongo 113-0033, Bunkyo-ku, Tokyo, Japan, E-mail:

  1. Research ethics: The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). This study protocol was approved by the Ethics Committee of both Juntendo University and Toho University (U18-0031).

  2. Informed consent: Informed consent was obtained from all individuals included in this study, or their legal guardians or wards.

  3. Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: None declared.

  6. Data availability: The raw data can be obtained on request from the corresponding author.

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Received: 2024-03-29
Accepted: 2024-07-20
Published Online: 2024-08-09
Published in Print: 2024-10-28

© 2024 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

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  2. Review
  3. Chorioamnionitis and respiratory outcomes in prematurely born children: a systematic review and meta analysis
  4. Opinion Paper
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  6. Corner of Academy
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  8. Original Articles – Obstetrics
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  10. Social vulnerability and prenatal diagnosis
  11. Perinatal outcomes in pregnant women with ITP: a single tertiary center experience
  12. Ability of an obstetric hemorrhage risk assessment tool to predict quantitative peripartum blood loss
  13. Sensitive detection of hemodynamic changes after fetoscopic laser photocoagulation by assessing intraventricular pressure difference in fetuses with twin-to-twin transfusion syndrome
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  18. Original Articles – Fetus
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  21. Short Communication
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https://doi.org/10.1515/jpm-2024-0147
Keywords for this article
diastolic function; echocardiography; fetoscopic laser surgery; intraventricular pressure difference; monochorionic twin; twin to twin transfusion syndrome

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Chorioamnionitis and respiratory outcomes in prematurely born children: a systematic review and meta analysis
  4. Opinion Paper
  5. Non-binary patients in ART: new challenges and considerations
  6. Corner of Academy
  7. KANET evaluation in patients with SARS-CoV-2
  8. Original Articles – Obstetrics
  9. Socioeconomic status as a risk factor for SARS-CoV-2 infection in pregnant women
  10. Social vulnerability and prenatal diagnosis
  11. Perinatal outcomes in pregnant women with ITP: a single tertiary center experience
  12. Ability of an obstetric hemorrhage risk assessment tool to predict quantitative peripartum blood loss
  13. Sensitive detection of hemodynamic changes after fetoscopic laser photocoagulation by assessing intraventricular pressure difference in fetuses with twin-to-twin transfusion syndrome
  14. Prevalence of restless legs syndrome during pregnancy and postpartum period
  15. Does atenolol use during pregnancy cause small for gestational age neonates? A meta-analysis
  16. Uterine isthmic tourniquet left in situ as a new approach for placenta previa-accreta surgery: a comparative study
  17. Maternal and newborn outcomes in pregnancies complicated by Guillain-Barré syndrome
  18. Original Articles – Fetus
  19. A customised fetal growth and birthweight standard for Qatar: a population-based cohort study
  20. Molecular analysis of 31 cases with fetal skeletal dysplasia
  21. Short Communication
  22. Current practice of ultrasound in the management of postpartum hemorrhage: a secondary analysis of a national survey
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