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Evaluation of cardiac performance by abdominal fetal ECG in twin‐to‐twin transfusion syndrome
Author(s) -
Velayo Clarissa,
Calvo Jesus Rodriguez,
Sato Naoaki,
Kimura Yoshitaka,
Yaegashi Nobuo,
Nicolaides Kypros
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.3956
Subject(s) - ductus venosus , medicine , fetus , twin to twin transfusion syndrome , cardiology , umbilical artery , obstetrics , gestation , pregnancy , genetics , biology
Objective To investigate fetal cardiac performance by abdominal fetal electrocardiography (ECG) in monochorionic diamniotic pregnancies with twin‐to‐twin transfusion syndrome (TTTS‐MCDA). Methods Abdominal fetal ECG was attempted in 16 singleton, 21 non‐TTTS‐MCDA, and 14 TTTS‐MCDA pregnancies at 16–27 weeks' gestation. Standard ECG parameters were compared across study groups and evaluated for their correlation with Doppler ultrasound indices. Results Clear P‐QRST complexes were recognized in all cases. In the TTTS‐MCDA pregnancies, the QT interval and QTc were significantly longer than in both singletons and the non‐TTTS‐MCDA pregnancies ( p = 0.002 and p = 0.0002, respectively), whereas in the recipient fetus, both the PR interval and PR/RR were significantly longer when compared with all other study groups ( p = 0.019 and p = 0.012, respectively). Further comparison with Doppler ultrasound indices yielded significant reciprocal correlations between ductus venosus pulsatility index and the QT interval ( r = 0.552, p = 0.041) and between umbilical artery pulsatility index and PR/RR ( r = 0.654, p = 0.011) both demonstrated in recipient fetuses alone. Conclusions Abdominal fetal ECG is feasible in second‐trimester twin pregnancies. In TTTS, there is evidence of a higher risk of cardiac dysfunction in the recipient twin. © 2012 John Wiley & Sons, Ltd.