Alterations in fetal doppler parameters before and twenty-four hours after radiofrequency ablation for twin reversed arterial perfusion sequence

Lan Zhang, Hongli Liu, Shuai Huang, Chao Tong, Zhigang Wang, Hongbo Qi, Philip N. Baker, Mark Kilby

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate alterations in the fetal Doppler parameters of pump fetuses
before and 24 h after radiofrequency ablation surgery for twin reversed arterial perfusion
sequence (TRAPs).
Methods: This is a retrospective study of 28 pump fetuses in TRAPs and 28 normal
control twins between 2016 and 2021. The fetal Doppler parameters, including the
umbilical artery pulsatility index (UA-PI), middle cerebral artery peak systolic velocity
(MCA-PSV), middle cerebral artery pulsatility index (MCA-PI), and cerebroplacental ratio
(CPR), of the controls, and pump fetuses before and 24 h after surgery were compared.
Results: An increasing trend and a further increase in the MCA-PSV, MCA-PI, MCAPSV Z score, and MCA-PI Z score after surgery were observed in pump fetuses with
gestational age (GA) ≥20 weeks; however, such changes were not observed in those
with a GA of <20 weeks. The UA-PI and CPR before and after surgery were not different
between control and pump fetuses, whether the GA was ≥20 or <20 weeks.
Conclusion: In the middle second trimester, the pump fetus might suffer from high
cardiac output rather than hypoxemia before surgery and congestive heart failure, or
hemodilutional anemia after surgery. This may provide some theoretical evidence in favor
of early intervention, rather than waiting for a more advanced GA, to avoid unnecessary
hemodynamic alterations.
Original languageEnglish
Article number802666
Number of pages7
JournalFrontiers in Medicine
Volume9
DOIs
Publication statusPublished - 14 Apr 2022

Bibliographical note

Not yet published as of 31/03/2022.

Keywords

  • middle cerebral artery
  • umbilical artery
  • doppler
  • radiofrequency ablation
  • monochorionic twin
  • twin reversed artery perfusion sequence

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