Incidence and characteristics of umbilical artery intermittent absent and/or reversed end‐diastolic flow in complicated and uncomplicated monochorionic twin pregnancies

Gratacós, E.; Lewi, Liesbeth; Carreras, Elena; Becker, Jorge; Higueras, Teresa; Deprest, Jan; Cabero, L.

doi:10.1002/uog.1013

Cited by 100 publications

(128 citation statements)

References 12 publications

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“…The reports by Gratacos et al 4,5,13 showed that sIUGR is associated with intermittent UA flow pattern (type III) and that the type of Doppler alteration is related to the number and diameter of artery-artery anastomoses. That prompted us to investigate if there were any differences between the sIUGR and nsIUGR groups regarding Doppler flow pattern.…”

Section: Discussionmentioning

confidence: 99%

“…A greater incidence of marginal or velamentous umbilical cord insertion, unequal sharing of the placental bed, and unbalanced arterio-venous anastomoses, with consequent compensatory mechanisms, make each monochorionic placenta an individual and atypical arrangement. 2,3 Gratacos et al, 4 in 2004, initiated a series of studies demonstrating increased neonatal morbidity in monochorionic and diamniotic (MCDA) pregnancies affected by sIUGR with abnormalities in Doppler velocimetry. In 2007, Gratacos et al, 5 comparing groups of sIUGR-affected MCDA pregnancies with different umbilical artery Doppler velocimetry patterns (normal Doppler, persistent absent or reversed end diastolic velocity flow, intermittent absent or reversed end diastolic velocity flow), reported, in the group with the latter pattern, a higher rate of intrauterine death (IUD) in the smaller fetus and of brain lesions in the larger fetus.…”

Section: Introductionmentioning

confidence: 99%

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Intrauterine growth restriction in monochorionic-diamniotic twins

Machado

Brizot

Miyadahira

et al. 2014

Rev. Assoc. Med. Bras.

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IntrauterIne growth restrIctIon In monochorIonIc-dIamnIotIc twIns rev assoc med Bras 2014; 60(6):585-590 585Original articleIntrauterine growth restriction in monochorionic-diamniotic twins Conflict of interest: noneObjective: to evaluate neonatal morbidity and mortality in monochorionic--diamniotic (MCDA) twin pregnancies complicated by selective intrauterine growth restriction (sIUGR) and non-selective intrauterine growth resctriction (nsIUGR). Methods: neonatal morbidity parameters and mortality were analyzed in 34 twins with IUGR (< 10 th percentile on twins' growth charts): 18 with sIUGR and 16 with nsIUGR. The sIUGR group was made up of 18 pregnancies in which growth was restricted in only one fetus (n = 18). The nsIUGR group was composed of 8 pregnancies in which both fetuses presented restricted growth (n = 16).Cases of twin-to-twin transfusion syndrome and fetal malformation were not included in the study. Results: the MCDA twin pregnancies with sIUGR had a higher rate of orotracheal intubation (p = 0.001) and mechanical ventilation (p = 0.0006), as well as longer than average fasting time (p = 0.014) compared to those in which the fetuses had nsIUGR. A higher incidence was also observed of types II and III umbilical artery Doppler velocimetry patterns in the sIUGR cases (p = 0.002). There was no significant difference between the two groups as to mortality during pregnancy and the neonatal period (p = 0.09). Conclusion: in MCDA twin pregnancies, sIUGR presents more severe umbilical artery Doppler velocimetry abnormalities and worse morbidity than nsIUGR.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intrauterine growth restriction in monochorionic-diamniotic twins

Machado

Brizot

Miyadahira

et al. 2014

Rev. Assoc. Med. Bras.

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“…Селективная задержка внутриутробного роста плода (СЗВРП) встречается примерно в 9,9% наблюдений моно-хориальных близнецов [14,17,18].…”

Section: таблица 1 исходы малоинвазивной лазерной коагуляции сосудовunclassified

“…R. Quintero и соавт. [14,18] позиционировали данный тип лечения как альтерна-тивный подход к лечению при СЗВРП у монохориальных двоен [4,14].…”

Section: таблица 1 исходы малоинвазивной лазерной коагуляции сосудовunclassified

“…В Европе в 2008 г. был разработан протокол ведения монохориальных двоен с СЗВУР на основе исследований Е. Gratacоs и J. Deprest [18], согласно которому крат-ность УЗИ при СЗВУР у монохориальных двоен состав-ляет 1 раз в 14 дней. При допплеровской кривой крово-тока в артерии пуповины типа II (0 или реверсный диа-столический кровоток) и III (перемежающийся) необхо-димо расширение протокола УЗИ: оцениваются систо-лическая скорость и индекс резистентности в среднемоз-говой артерии и кровоток в венозном протоке.…”

Section: таблица 2 исходы лазерной коагуляции сосудов пуповины при ффтсunclassified

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Selective feticide in complicated monochorionic twin or dichorionic triplet pregnancies applying laser coagulation of umbilical cord vessels

Kosovtsova¹,

Башмакова²,

Маркова³

et al. 2016

Ross. vestn. akush.-ginekol.

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Umbilical Artery Doppler Patterns and Right Ventricular Outflow Abnormalities in Twin‐Twin Transfusion Syndrome

Espinoza

Furtun

Kailin

et al. 2020

J of Ultrasound Medicine

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Objectives-To evaluate the association of abnormal Doppler velocimetric patterns in the umbilical arteries (UAs) and right ventricular outflow tract abnormalities (RVOTAs) in twin-twin transfusion syndrome (TTTS) cases. Methods-This retrospective study involved women who had laser surgery for TTTS between January 2012 and May 2018 at a single institution. The prevalence of an RVOTA in either twin was compared among TTTS cases in which both twins had positive end-diastolic flow (EDF) in the UA and those in which either twin had intermittent or persistent absent/reversed UA EDF. Nonparametric tests were used for comparisons. Logistic regression was performed to identify variables associated with an RVOTA in either twin, adjusted for moderate or severe tricuspid regurgitation, right ventricular hypertrophy, right ventricular systolic or diastolic dysfunction, the Quintero stage, and other confounders. P < .05 was considered significant. Results-A total of 126 consecutive TTTS cases were included. Right ventricular outflow tract abnormalities were seen in 8.7% (11of 126) of cases, all in recipient twins. Significant differences in the rate of RVOTAs in the recipient twin were seen between TTTS cases with intermittent absent/reversed UA EDF and those with positive UA EDF (26.9% [7 of 26] versus 3.7% [3 of 82]; P = .002]. However, no significant differences were noted among the other study groups. Intermittent absent/reversed UA EDF was associated with a significantly increased risk for an RVOTA (adjusted odds ratio, 20.6 [95% confidence interval, 3.1-138]; P = .002) after adjusting for confounders. Conclusions-Intermittent changes in vascular impedance to UA flow may contribute to the pathogenesis of acquired right-sided cardiac lesions in the recipient twin affected with TTTS.

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Incidence and characteristics of umbilical artery intermittent absent and/or reversed end‐diastolic flow in complicated and uncomplicated monochorionic twin pregnancies

Abstract: Objective

Cited by 100 publications

References 12 publications

Intrauterine growth restriction in monochorionic-diamniotic twins

Intrauterine growth restriction in monochorionic-diamniotic twins

Selective feticide in complicated monochorionic twin or dichorionic triplet pregnancies applying laser coagulation of umbilical cord vessels

Umbilical Artery Doppler Patterns and Right Ventricular Outflow Abnormalities in Twin‐Twin Transfusion Syndrome

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