Doppler velocimetry determined redistribution of fetal blood flow: Correlation with growth restriction in diamniotic monochorionic and dizygotic twins

Gaziano, Emanuel P.; Gaziano, Cecilie; Brandt, Debra G.

doi:10.1016/s0002-9378(98)70344-8

Cited by 46 publications

(30 citation statements)

References 17 publications

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“…Monochorionic diamniotic pregnancies with and without TTTS have significantly greater blood flow redistributions in the cerebral circulation when compared with dizygotic twins. 20 In one small study, the donor twin demonstrated increased resistance in the MCA, perhaps indicating decompensation of the fetal cerebral circulation. 21 Mari et al 6 studied four sets of fetuses with TTTS undergoing amnioreduction at 25-26 weeks.…”

Section: Discussionmentioning

confidence: 99%

Fetal middle cerebral artery Doppler fluctuations after laser surgery for twin–twin transfusion syndrome

et al. 2010

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Objective: The objective of this study was to compare alterations in the middle cerebral artery (MCA) pulsatility index (PI) and mean velocity (V mean ) after laser surgery for twin-twin transfusion syndrome (TTTS).Study Design: MCA Doppler studies were conducted 1 day before and after laser surgery for TTTS. The pre-and postoperative mean (standard deviation) of the MCA PI and V mean z-scores of the recipient and donor fetuses were calculated and compared. Data were analyzed using paired testing and multivariable linear regression models.Results: A total of 103 patients met the study criteria. Recipients' MCA PI increased from À1.29 (1.20) preoperatively to 0.14 (1.52) postoperatively (P<0.0001), whereas the donors' PI did not change significantly (À0.31 (1.67) to À0.67 (1.29); P ¼ 0.12). There was no significant difference between preoperative and postoperative MCA V mean in donors (0.39 (0.83) and 0.38 (0.93), respectively; P ¼ 0.5048) or recipients (0.60 (0.74) and 0.63 (0.90), respectively; P ¼ 0.5324).Conclusions: Despite the changes in the MCA PI after laser surgery for TTTS, the MCA V mean remained constant. These findings may suggest some autoregulatory capacity in the cerebral vessels of the mid-trimester fetus.

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Section: Discussionmentioning

confidence: 99%

Fetal middle cerebral artery Doppler fluctuations after laser surgery for twin–twin transfusion syndrome

et al. 2010

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“…This finding may have to do with abnormal placental vasculature or growth restriction in the DT group. An abnormal CPR has been reported in up to 42% of lowweight monochorionic-diamniotic twins, 49 in whom it was found to correlate with adverse neonatal outcomes. 14 Our findings must be viewed in light of the strengths as well as the inherent limitations of the study.…”

Section: Discussionmentioning

confidence: 99%

Diastolic Dysfunction and Cerebrovascular Redistribution Precede Overt Recipient Twin Cardiomyopathy in Early-Stage Twin-Twin Transfusion Syndrome

Votava‐Smith

Habli

Cnota

et al. 2015

Journal of the American Society of Echocardiography

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“…Different trends in Doppler serial recordings were found according to the underlying mechanism of growth defect. Diamniotic monochorionic twins from the lower birth weight group more often show blood flow redistribution compared with dizygotic twins of similar low birth weight [70] . Placental vascular connections and the attendant hemodynamic changes in this group probably account for this difference.…”

Section: Complicated Pregnancies and Deliveriesmentioning

confidence: 93%

Fetal Cerebrovascular Circulation: A Review of Prenatal Ultrasound Assessment

Degani¹

2008

Gynecol Obstet Invest

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Antenatal intrauterine cerebrovascular events were found to play an important role in the pathogenesis of perinatal brain damage. Changes in placental vascular resistance, cardiac contractibility, vessel compliance, and blood viscosity alter the normal dynamics of fetal cerebral circulation. The circulatory mechanisms described in animal fetuses also operate in the human fetus. The isthmus of the aorta represents a watershed area reflecting the redistribution of blood during increased peripheral resistance and hypoxia. The fetal cerebrovascular system acts locally within the skull and interacts with the other components of fetal circulation to compensate by redistribution of blood in case of shortage in resources. The introduction of various sonographic techniques and the collection of data from the arterial and venous cerebral circulation have improved our understanding of the regulatory mechanisms involved in fetal cerebral hemodynamic events. Anatomical and physiological considerations of cerebral vasculature in health and disease are relevant in the research of variations in fetal brain blood perfusion. Changes in flow characteristics in fetal cerebral vasculature can be used for clinical decisions. However, caution is advised before applying research data into practice. The clinical utility is well established in situations of fetal compromise such as growth restriction and anemia.

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Doppler velocimetry determined redistribution of fetal blood flow: Correlation with growth restriction in diamniotic monochorionic and dizygotic twins

Cited by 46 publications

References 17 publications

Fetal middle cerebral artery Doppler fluctuations after laser surgery for twin–twin transfusion syndrome

Fetal middle cerebral artery Doppler fluctuations after laser surgery for twin–twin transfusion syndrome

Diastolic Dysfunction and Cerebrovascular Redistribution Precede Overt Recipient Twin Cardiomyopathy in Early-Stage Twin-Twin Transfusion Syndrome

Fetal Cerebrovascular Circulation: A Review of Prenatal Ultrasound Assessment

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