Evaluation of the measurement of the middle cerebral artery peak systolic velocity before and after placental laser coagulation in twin-to-twin transfusion syndrome

ABSTRACT Objective The aim of this study is to evaluate the incidence of elevated middle cerebral artery peak systolic velocity (MCA‐PSV) in twin‐to‐twin transfusion syndrome (TTTS) before and after laser and its predictive value for intrauterine fetal death (IUFD) occurring within 2 to 7 days follo...

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Published in:Prenatal diagnosis 2012-02, Vol.32 (2), p.127-130
Main Authors: Trieu, Ngoc-Tu, Weingertner, A. S., Guerra, F., Dautun, D., Kohler, M., Vayssière, C., Nisand, I., Favre, R.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Blood Flow Velocity - physiology
Cerebrovascular Circulation
Female
Fetal Death
Fetofetal Transfusion - mortality
Fetofetal Transfusion - physiopathology
Fetofetal Transfusion - surgery
Humans
Laser Coagulation
Middle Cerebral Artery - diagnostic imaging
Middle Cerebral Artery - physiopathology
Middle Cerebral Artery - surgery
Placenta - blood supply
Postoperative Complications
Pregnancy
Prognosis
Retrospective Studies
Systole - physiology
Twins, Monozygotic
Ultrasonography
Young Adult
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Summary:ABSTRACT Objective The aim of this study is to evaluate the incidence of elevated middle cerebral artery peak systolic velocity (MCA‐PSV) in twin‐to‐twin transfusion syndrome (TTTS) before and after laser and its predictive value for intrauterine fetal death (IUFD) occurring within 2 to 7 days following laser. Method This is a 5‐year retrospective single‐center study on 86 consecutive laser procedures for TTTS. MCA‐PSV was measured prior to and 48 h following laser. We correlated perioperative MCA‐PSV and fetal survival within 7 days following laser. Results The incidence of elevated MCA‐PSV prior to and following laser (NS) was 8.2% to 9.7% (non significant (NS)). There was no correlation between the incidence of an elevated MCA‐PSV prior to laser and fetal survival up to 7 days after laser (NS, χ 2: 3.49). In contrast, the presence of an MCA‐PSV above 1.5 MoM 48 h following laser in the former donor puts the former donor at a higher risk for IUFD within a week after surgery [odds ratio (OR): 3.42 (interval of confidence (IC) 95%: 1.9–30.6), χ 2: 8.68, p 
ISSN:0197-3851
1097-0223
DOI:10.1002/pd.2907