Predictive value of cardiovascular parameters in twin‐to‐twin transfusion syndrome. (October 2014)

• Record Type: Journal Article
• Authors: Gapp‐Born, E.; Sananes, N.; Weingertner, A. S.; Guerra, F.; Kohler, M.; Fritz, G.; Viville, B.; Gaudineau, A.; Langer, B.; Sauleau, E.; Nisand, I.; Favre, R.
• Is Part Of: Ultrasound in obstetrics & gynecology. Volume 44:Number 4(2014:Oct.)
• Page Start: 427
• Page End: 433
• Publication Date: 2014-10
• Subjects: Ultrasonics in obstetrics -- Periodicals; Generative organs, Female -- Diseases -- Diagnosis -- Periodicals; Diagnosis, Ultrasonic -- Periodicals; Genital Diseases, Female -- ultrasonography -- Periodicals; Ultrasonography, Prenatal -- Periodicals; 618.047543
• DOI: 10.1002/uog.13351
• Languages: English
• ISSNs: 0960-7692

Abstract

<abstract abstract-type="main" id="uog13351-abs-0001"> <title>ABSTRACT</title> <sec id="uog13351-sec-0001" sec-type="section"> <title>Objective</title> <p id="uog13351-para-0001">To evaluate the prognostic value of the Children's Hospital Of Philadelphia (CHOP) cardiovascular score and the modified myocardial performance index (MPI), in determining the risk of recipient fetal loss in twin‐to‐twin transfusion syndrome (TTTS).</p> </sec> <sec id="uog13351-sec-0002" sec-type="section"> <title>Methods</title> <p id="uog13351-para-0002">This cohort study was based on data collected prospectively from 105 pregnancies complicated by TTTS (Quintero stages I–IV) and treated with laser photocoagulation between May 2008 and February 2013. Fetuses underwent detailed anatomical and Doppler ultrasonography with cardiac assessment as part of routine care. CHOP score and right MPI were calculated and cut‐offs selected using receiver–operating characteristics curve analysis. These were compared according to loss of recipient fetus, using univariate and multivariate logistic regression. The correlation between CHOP score, MPI and Quintero stage was determined and we investigated differences in MPI before and after laser coagulation in a cohort of 90 recipient fetuses.</p> </sec> <sec id="uog13351-sec-0003" sec-type="section"> <title>Results</title> <p id="uog13351-para-0003">Rates of recipient fetal loss were significantly higher when the CHOP score was ≥ 3 (39.5% <italic>vs</italic> 12.9%, <italic>P</italic> = 0.002) and when MPI <italic>z</italic>‐score was > 1.645 (34.5% <italic>vs</italic> 10.6%, <italic>P</italic> = 0.004). After adjustment for Quintero stage, the risk of recipient fetal loss remained significantly higher when the CHOP score was ≥ 3 (odds ratio, 3.09; 95% CI, 1.035–9.21). There was a positive correlation between CHOP score, MPI and Quintero stage. MPI was significantly lower after compared with before laser coagulation.</p> </sec> <sec id="uog13351-sec-0004" sec-type="section"> <title>Conclusion</title> <p id="uog13351-para-0004">CHOP score and MPI are predictors of recipient fetal loss in TTTS and may be used to supplement Quintero's classification. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.</p> </sec> </abstract>