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.
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 language | English |
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Article number | 802666 |
Number of pages | 7 |
Journal | Frontiers in Medicine |
Volume | 9 |
DOIs | |
Publication status | Published - 14 Apr 2022 |
Bibliographical note
Not yet published as of 31/03/2022.Keywords
- doppler
- middle cerebral artery
- monochorionic twin
- radiofrequency ablation
- twin reversed artery perfusion sequence
- umbilical artery