P29.02: Maternal hemodynamic in monochorionic twin pregnancy: hypodynamic circulation and reduced cardiac power

Abstract

grade should be assessed longitudinally as the change over time provides additional value for risk prediction. P28.08Thorax-to-head ratio and defect diameter-to-head ratio in giant omphaloceles as predictor for fetal outcome Objectives: To investigate the relationship between the thorax diameter and defect diameter of giant omphaloceles as a predictor for fetal outcome. Methods: In a retrospective study, 17 fetuses with isolated giant omphaloceles were included for evaluation. The anterior-posterior thorax diameter and the defect diameter were measured from ultrasound images. For analysis, the thorax-to-head ratio (T/HC), the defect diameter-to-head ratio (DD/HC), and the quotient of the defect diameter and the thorax diameter (DD/T) were calculated. The days of ventilation (t ventilation ), the duration until hospital discharge (t hospital ), and the type of treatment were recorded as outcome parameters. Results: No relationship was found between the calculated ratios (T/HC, DD/HC, or DD/T) and neither t hospital (r = -0.418, p = 0.095; r = -0.153, p = 0.556; and r = -0.023, p = 0.929; respectively) nor t ventilation (r = -0.391, p = 0.121; r = 0.041, p = 0.875; and r = 0.121, p = 0.645, respectively). The type of postnatal treatment was not associated with the three calculated ratios or t hospital (r = 0.155, p = 0.553; r = 0.019, p = 0.942; and r = 0.012, p = 0.965; r = -0.009, p = 0.973, respectively). In 53% of cases, t hospital was delayed due to additional and independent postnatal complications. Conclusions: Thorax diameter or defect diameter of giant omphaloceles is not predictive for fetal outcome. The perinatal care of these abdominal wall defects still remains a multidisciplinary challenge, but the outcome of giant omphaloceles is favourable at experienced centres. P29: IMPROVING OUR MANAGEMENT OF TWIN PREGNANCIES P29.01Maternal hemodynamic changes and complications following intrauterine interventions for monochorionic twin pregnancies P. Greimel, A. Zenz, B. Csapo, P. Klaritsch Department of Obstetrics and Gynecology, Medical University of Graz, Graz, AustriaObjectives: Twin-twin transfusion syndrome (TTTS) is a challenging complication in monochorionic twin pregnancies. TTTS is caused by placental anastomoses, facilitating unbalanced flow between the two fetuses resulting in compromised circulation of one twin while the other one suffers from volume overload. This leads to stepwise deterioration and finally to death of one or both fetuses if untreated.State-of-the-art treatment for TTTS is intrauterine laser coagulation of connecting placental anastomoses. At the end of this procedure, drainage of amniotic fluid is routinely performed. Following high-volume drainage of amniotic fluid, maternal hemodynamic effects such as hypovolemia, oliguria and hemodilution can be observed.We aimed to report on maternal hemodynamic changes and complications after intrauterine interventions for TTTS. Methods: We conducted a retrospective single centre analysis in 80 cases of TTTS treated with intrauterine laser c...

Maternal Hemodynamics from Preconception to Delivery: Research and Potential Diagnostic and Therapeutic Implications: Position Statement by Italian Association of Preeclampsia and Italian Society of Perinatal Medicine

“…These variability in data should be interpreted with caution, and the differences in findings may also be gestational age-dependent: some studies adopted a longitudinal design, [58][59][60] while others pooled together cross-sectional observations in different trimesters 62 or just in mid-pregnancy. 61 Finally, the effect of chorionicity is debated: a recent report 63 showed that women with monochorionic twin pregnancies had a higher PKR and TPVR index in the third trimester, with lower SV and INO versus singleton pregnancies. These differences were not observed in dichorionic (DC) twin pregnancies.…”

“…These differences were not observed in dichorionic (DC) twin pregnancies. 63 Mothers of monochorionic twins may have less extreme cardiovascular adaptation compared with DC, but the magnitude of such difference may be minor. 6,61 Recommendation (research):…”

“…Moreover, alongside these widely studied areas, interesting data are emerging regarding other pregnancy diseases such as diabetes and preterm delivery (PTD), as well as a potential role of hemodynamics before pregnancy, in FGR, during tween pregnancy, labor, and delivery with the anesthesiologic implications of hemodynamic profile of the mothers. 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106…”