Early postnatal cardiac follow-up of survivors of twin-twin transfusion syndrome treated with fetoscopic laser coagulation.

Autor: Gijtenbeek M; Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands. m.gijtenbeek@lumc.nl., Haak MC; Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands., Eschbach SJ; Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands., Buijnsters ZA; Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands., Middeldorp JM; Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands., Klumper FJCM; Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands., Oepkes D; Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands., Ten Harkel ADJ; Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2020 Sep; Vol. 40 (9), pp. 1375-1382. Date of Electronic Publication: 2020 Mar 09.
DOI: 10.1038/s41372-020-0645-x
Abstrakt: Objective: To assess the cardiac function and prevalence of congenital heart defects (CHD) in twin-twin transfusion syndrome (TTTS) survivors.
Study Design: Prospective follow-up of TTTS pregnancies treated with laser surgery (2015-2018). Echocardiography was performed 1 day and 1 month after birth (corrected for prematurity). Results were compared with a control group of age-matched uncomplicated monochorionic twin-pairs at 1 month.
Result: Eighty-nine TTTS (168 neonates) and nine control pregnancies (18 neonates) were enrolled. CHD birth prevalence was 9.2% (8/87) in recipients and 13.6% (11/81) in donors (p = 0.37). Four of 19 (21%) were detected prenatally, all pulmonary stenosis. Donors had lower aortic peak velocities compared with recipients at day 1 (0.66 ± 0.15 m/s vs 0.71 ± 0.19 m/s, p = 0.04) and 1 month (1.04 ± 0.21 m/s vs 1.11 ± 0.18 m/s, p = 0.02), but not compared with controls.
Conclusion: CHD prevalence in TTTS survivors is high, with a low prenatal detection of minor abnormalities. Follow-up fetal echocardiograms and a postnatal echocardiogram should be offered.
Databáze: MEDLINE
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