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Evaluation of the measurement of the middle cerebral artery peak systolic velocity before and after placental laser coagulation in twin‐to‐twin transfusion syndrome
Author(s) -
Trieu NgocTu,
Weingertner A. S.,
Guerra F.,
Dautun D.,
Kohler M.,
Vayssière C.,
Nisand I.,
Favre R.
Publication year - 2012
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2907
Subject(s) - middle cerebral artery , medicine , odds ratio , twin to twin transfusion syndrome , incidence (geometry) , confidence interval , laser coagulation , perioperative , laser surgery , cardiology , fetus , surgery , laser , pregnancy , ischemia , physics , visual acuity , biology , optics , genetics
Objective The aim of this study is to evaluate the incidence of elevated middle cerebral artery peak systolic velocity (MCA‐PSV) in twin‐to‐twin transfusion syndrome (TTTS) before and after laser and its predictive value for intrauterine fetal death (IUFD) occurring within 2 to 7 days following laser. Method This is a 5‐year retrospective single‐center study on 86 consecutive laser procedures for TTTS. MCA‐PSV was measured prior to and 48 h following laser. We correlated perioperative MCA‐PSV and fetal survival within 7 days following laser. Results The incidence of elevated MCA‐PSV prior to and following laser (NS) was 8.2% to 9.7% (non significant (NS)). There was no correlation between the incidence of an elevated MCA‐PSV prior to laser and fetal survival up to 7 days after laser (NS, χ 2 : 3.49). In contrast, the presence of an MCA‐PSV above 1.5 MoM 48 h following laser in the former donor puts the former donor at a higher risk for IUFD within a week after surgery [odds ratio (OR): 3.42 (interval of confidence (IC) 95%: 1.9–30.6), χ 2 : 8.68, p < 0.003]. Conclusion The occurrence of an elevated MCA‐PSV following laser is related to postoperative donor death within 2 to 7 days after laser. © 2012 John Wiley & Sons, Ltd.