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F43Feto‐placental Doppler measurements pre and post laser coagulation in severe twin–twin transfusion syndrome
Author(s) -
Carreras E.,
Deprest J.,
Van Schoubroeck D.,
Roma L.,
Van Assche A.,
Cabero L.,
Gratacos E.
Publication year - 2000
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2000.00015-1-43.x
Subject(s) - medicine , ductus venosus , fetus , laser coagulation , anastomosis , umbilical artery , umbilical vein , fetoscopy , twin to twin transfusion syndrome , twin twin transfusion syndrome , cardiology , hemodynamics , laser doppler velocimetry , vein , coagulation , surgery , blood flow , pregnancy , prenatal diagnosis , biochemistry , genetics , chemistry , visual acuity , in vitro , biology
Objective The aim of the study was to know what fetal hemodynamic response to therapeutical fetoscopic laser was, specially in the donor. Material and methods Patients with severe TTS undergoing laser coagulation of placental anastomoses ( n = 25) were included. Doppler measurements (Accuson Aspen) were performed in the Umbilical artery, Middle cerebral artery, ductus venosus and Umbilical vein of both fetuses preoperatively and on days 1, 3 and 5 postlaser. Results Venous pulsatility indices tend to decrease in the recipient while they increase in the donor. Increased PI and/or appearance of pulsations in the UV was observed in 75% of donors, which was accompanied but one or more signs of hydrops in 20% of cases. These did not constitute signs of poor prognosis. Conclusions We hypothesize that venous return in the donor fetus increases after laser coagulation, which could explain a transient overload phase, which in any case does not imply a poorer prognosis.