Is pulsed Doppler velocimetry useful in the management of multiple-gestation pregnancies?

Gaziano, Emanuel P.; Knox, George; Bendel, Richard P.; Calvin, Steven E.; Brandt, Deb

doi:10.1016/0002-9378(91)91420-2

Cited by 46 publications

(27 citation statements)

References 10 publications

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“…Similarly, as reported previously, Doppler investigation of the umbilical artery was not contributive 38 ; as could be expected, a greater value was observed for the PIUA of the smaller fetus with placental circulatory insufficiency, but the difference was not yet significant at this early stage of the disease. Higher peak velocity has been reported in the MCA of the smaller twin in TTTS, 39 which reflects circulatory adjustment to anemia.…”

Section: Discussionsupporting

confidence: 88%

Early Intertwin Differences in Myocardial Performance During the Twin-to-Twin Transfusion Syndrome

et al. 2004

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Background-In the twin-to-twin transfusion syndrome (TTTS), pressure rather than volume overload is increasingly considered as a key factor in the pathogenesis of the cardiomyopathy of the recipient twin. If this is the case, cardiac dysfunction should be among the first signs observed with TTTS. The objective of this study was to determine whether intertwin differences in myocardial function are modified early in the course of TTTS and whether they can help to differentiate this condition from intrauterine growth restriction (IUGR). Methods and Results-Eight variables were analyzed on the first fetal echocardiography on 21 pairs of twins with TTTS and 11 with IUGR. No difference was found between the 2 groups for the cardiothoracic ratio, pulsatility indices in the umbilical and middle cerebral arteries, and peak velocity of the middle cerebral artery. Significant difference was found for ventricular septal thickness, but with no association with the conditions under study. With TTTS, left ventricular shortening fraction was consistently greater in the donor twins, and myocardial performance indices (MPIs) were elevated in the recipient twins. This increase in MPI was caused by a lengthening of the isovolumic periods compared with those of the donor twin: left ventricular and right ventricular isovolumic periods 0.105Ϯ0.047 and 0.097Ϯ0.026 seconds, respectively, for the recipient twins versus 0.0561Ϯ0.46 and 0.065Ϯ0.03 seconds, respectively, for the donor twins (PϽ0.001). These changes in the isovolumic periods were mainly due to significant prolongation of isovolumic relaxation times. A change in left ventricular MPI Ն0.09 combined with a change in right ventricular MPI Ն0.05 would identify a TTTS with a sensitivity of 75% and a false-positive rate of 9%. Conclusions-The observed diastolic function impairment goes along with the pressure-overload pathogenic concept proposed in TTTS. Assessment of intertwin difference in MPI is a valuable tool for early differential diagnosis between TTTS and isolated IUGR.

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Section: Discussionsupporting

confidence: 88%

Early Intertwin Differences in Myocardial Performance During the Twin-to-Twin Transfusion Syndrome

et al. 2004

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“…Thus, the possibility in differences in foetal Doppler data in multiple pregnancies should be considered. There are some data regarding singleton and multiple pregnancies from human medicine (21,23,24), but only one report in veterinary practice (16). In the current study, the authors sought to compare biometric parameters for single and twin foetuses, in addition to UA Doppler measurements throughout the pregnancy, in healthy Karya ewes.…”

Section: Introductionmentioning

confidence: 99%

Comparison of foetal growth in singleton and twin pregnancies byB-mode and Doppler ultrasonography in Karya ewes

Erdoğan¹,

Çetin²,

Ceylan³

et al. 2016

Turk J Vet Anim Sci

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“…Anormal A/B oranları artmış perinatal mortalite ve ciddi morbidite bulgusudur. Yapılan çalışmalar ikiz gebeliklerdeki anormal A/B oranlarının uyumsuz gelişim veya gestasyon yaşına göre küçük-lük (SGA) için yaklaşık %80 oranında duyarlı-lık ve %70-90 oranında pozitif öngörü değerine sahip olduğunu göstermektedir [29].…”

Section: Doppler İncelemeunclassified

Cogul Gebeliklerde Ultrasonografi

Güven¹,

Kantarcı²

2017

Trd Sem

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Çoğul Gebeliklerde İnsidansSon yıllarda, ilerleyen anne yaşı ve üreme tekniklerinin kullanımının artması nedeniyle çoğul gebelik insidansında belirgin artış gözlenmekte-dir. İkiz gebeliklerin yaklaşık %50'si; üçüz ya da daha fazla sayıda olanların ise çoğu erken ya da düşük doğum ağırlıklı dünyaya gelmektedir. İkiz gebeliklerde, embriyo sayısı üç ve üzeri olanlardan daha düşük olmakla birlikte, perinatal ölümlerin yaklaşık %12'si çoğul gebeliklerde görülmektedir. İkizlerde perinatal ölüm oranı tekil gebeliklerden 5-10 kat daha fazladır. Çoğul gebelikler aynı zamanda artmış düşük insidansının yanısıra çeşitli fetal ve maternal komplikasyonlar açısından da artmış risk taşırlar. Ço-ğul gebelikler antepartum dönemde daha fazla gözetim gerektiren yüksek riskli gebelikler olup ileri merkezlerde doğum planlanmalıdır [1][2][3][4]. Koryonisite ve Zigositeİkiz gebelikler iki ayrı ovumun döllenme-siyle (dizigotik) veya tek bir ovumun bölün-

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Is pulsed Doppler velocimetry useful in the management of multiple-gestation pregnancies?

Cited by 46 publications

References 10 publications

Early Intertwin Differences in Myocardial Performance During the Twin-to-Twin Transfusion Syndrome

Early Intertwin Differences in Myocardial Performance During the Twin-to-Twin Transfusion Syndrome

Comparison of foetal growth in singleton and twin pregnancies byB-mode and Doppler ultrasonography in Karya ewes

Cogul Gebeliklerde Ultrasonografi

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