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Impact of middle cerebral artery pulsatility index on donor survival in twin-twin transfusion syndrome. | LitMetric
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Impact of middle cerebral artery pulsatility index on donor survival in twin-twin transfusion syndrome.

Eyal Krispin Alireza A Shamshirsaz Hiba J Mustafa Raphael C Sun Jimmy Espinoza Ahmed A Nassr Magdalena Sanz-Cortes Chilaka H Ugoji Christopher Harman Ozhan Turan Michael A Belfort Roopali Donepudi

Prenat Diagn

Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery, Baylor College of Medicine and Texas Children's Fetal Center, Houston, Texas, USA.

Published: January 2023

AI Article Synopsis

  • The study aimed to evaluate the outcomes of twin-twin transfusion syndrome (TTTS) based on the middle cerebral artery pulsatility index (MCA-PI) before fetoscopic laser photocoagulation (FLPC) surgery.
  • A retrospective analysis of monochorionic twins affected by TTTS revealed that abnormal MCA-PI was present in 17.7% of cases, which was linked to higher rates of severe fetal growth restriction (sFGR) and decreased survival rates for the donor twin within 48 hours after surgery.
  • Findings suggest that an abnormal MCA-PI is associated with significantly lower survival rates for the donor twin at delivery and 30 days post-birth, indicating its potential importance in assessing prognosis in TTTS

Article Abstract

Objective: To assess outcomes in twin-twin transfusion syndrome (TTTS) according to middle cerebral artery pulsatility index (MCA-PI) prior to fetoscopic laser photocoagulation (FLPC) surgery.

Methods: A retrospective cohort analysis of monochorionic-twin pregnancies complicated by TTTS who underwent FLPC at two fetal centers (2012-2021). The cohort was stratified according to abnormal MCA-PI of the donor twin, defined as below fifth centile for gestational age.

Results: Abnormal MCA-PI of the donor twin was detected in 46 (17.7%) cases compared to 213 (83.3%) controls with no such abnormality. The abnormal PI group presented with higher rates of sFGR (56.5% vs. 36.8% in controls, p = 0.014) and lower donor survival rates within 48 h after FLPC (73.9 vs. 86.8%, p = 0.029). Donor twin survival rates at the time of delivery and 30 days after birth were lower in the abnormal MCA-PI. Multivariate logistic regression analysis controlling for sFGR and MCA-PI
Conclusions: Donor survival at the time of delivery and 30 days after birth was lower in TTTS cases with MCA-PI

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 Source
http://dx.doi.org/10.1002/pd.6288DOI Listing

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