Premium
Instability of Doppler Cerebral Blood Flow in Monochorionic Twins
Author(s) -
Degani Shimon,
Leibovitz Zvi,
Shapiro Israel,
Gonen Ron,
Ohel Gonen
Publication year - 2006
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2006.25.4.449
Subject(s) - medicine , cerebral blood flow , doppler effect , monochorionic twins , blood flow , cardiology , pregnancy , fetus , physics , astronomy , biology , genetics
Objective. The purpose of this study was to evaluate Doppler flow velocity changes in cerebral vessels of monochorionic twins with twin‐twin transfusion syndrome (TTTS). Methods. Repeated Doppler umbilical and cerebral blood flow studies were performed in 7 twin pairs with TTTS. Eight monochorionic twin pairs and 11 dichorionic twin pairs served as control groups. The following Doppler parameters were assessed: umbilical artery pulsatility index (PI), middle cerebral artery (MCA) PI, cerebroplacental ratio, delta PI between the umbilical artery and MCA, and peak systolic velocity (PSV) in the MCA. Results. Significant variations in PSV in the MCA and cerebral indices were found in the study group of monochorionic twins with TTTS. Periods of high PSV with low PI in the MCA were followed by lower PSV in the same fetus. Repeated measurements in the comparison groups were stable without significant variations. The delta cerebroplacental ratio was significantly higher in the study group (0.38 versus 0.09 and 0.19 in the comparison groups; P < .02). Conclusions. Significant changes in Doppler flow velocity and indices suggest instability of cerebral blood flow with episodes of “hyperperfusion” in monochorionic twins with TTTS. Further studies are needed to elucidate the relationship of these transient changes to neurologic sequelae in the neonate.