TY - JOUR
T1 - The twin-twin transfusion syndrome
T2 - spectrum of cardiovascular abnormality and development of a cardiovascular score to assess severity of disease
AU - Rychik, Jack
AU - Tian, Zhiyun
AU - Bebbington, Michael
AU - Xu, Feng
AU - McCann, Margaret
AU - Mann, Stephanie
AU - Wilson, R. Douglas
AU - Johnson, Mark P.
PY - 2007/10
Y1 - 2007/10
N2 - Objective: Current means of grading twin-twin transfusion syndrome does not characterize cardiovascular aspects adequately. We sought to develop a score that describes the magnitude of cardiovascular severity in twin-twin transfusion syndrome. Study Design: Fetal echocardiograms of 150 monochorionic/diamniotic twins were reviewed. Blinded to Quintero stage, we applied a cardiovascular score to each twin set and compared it to the Quintero grade. The score is a composite of variables that include ventricular hypertrophy, dilation, function, valve regurgitation, great artery size, and diastolic properties in the recipient and umbilical artery flow in the donor. Doppler indices of vascular and ventricular function were measured. Results: Mean age was 21 ± 3 weeks. Discrepancy was noted in degree of severity between Quintero and cardiovascular stages. The score correlated well with myocardial performance index of the recipient right ventricle (r2 = .65). Conclusion: We describe the spectrum of cardiovascular abnormalities that are seen in twin-twin transfusion syndrome and propose a scoring system for assessment of severity.
AB - Objective: Current means of grading twin-twin transfusion syndrome does not characterize cardiovascular aspects adequately. We sought to develop a score that describes the magnitude of cardiovascular severity in twin-twin transfusion syndrome. Study Design: Fetal echocardiograms of 150 monochorionic/diamniotic twins were reviewed. Blinded to Quintero stage, we applied a cardiovascular score to each twin set and compared it to the Quintero grade. The score is a composite of variables that include ventricular hypertrophy, dilation, function, valve regurgitation, great artery size, and diastolic properties in the recipient and umbilical artery flow in the donor. Doppler indices of vascular and ventricular function were measured. Results: Mean age was 21 ± 3 weeks. Discrepancy was noted in degree of severity between Quintero and cardiovascular stages. The score correlated well with myocardial performance index of the recipient right ventricle (r2 = .65). Conclusion: We describe the spectrum of cardiovascular abnormalities that are seen in twin-twin transfusion syndrome and propose a scoring system for assessment of severity.
KW - cardiomyopathy
KW - fetal echocardiography
KW - twin-twin transfusion syndrome
KW - twins
UR - http://www.scopus.com/inward/record.url?scp=34648813699&partnerID=8YFLogxK
U2 - 10.1016/j.ajog.2007.06.055
DO - 10.1016/j.ajog.2007.06.055
M3 - Article
C2 - 17904973
AN - SCOPUS:34648813699
SN - 0002-9378
VL - 197
SP - 392.e1-392.e8
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 4
ER -