Early postnatal cardiac follow-up of survivors of twin-twin transfusion syndrome treated with fetoscopic laser coagulation

To assess the cardiac function and prevalence of congenital heart defects (CHD) in twin-twin transfusion syndrome (TTTS) survivors. Prospective follow-up of TTTS pregnancies treated with laser surgery (2015-2018). Echocardiography was performed 1 day and 1 month after birth (corrected for prematurit...

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Bibliographic Details
Published in:Journal of perinatology 2020-09, Vol.40 (9), p.1375-1382
Main Authors: Gijtenbeek, Manon, Haak, Monique C, Eschbach, Sanne J, Buijnsters, Zoë A, Middeldorp, Johanna M, Klumper, Frans J C M, Oepkes, Dick, Ten Harkel, Arend D J
Format: Article
Language:English
Subjects:
Abnormalities
Aorta
Birth
Cardiac function
Coagulation
Congenital heart disease
Coronary heart disease
Coronary vessels
Design defects
Echocardiography
Fetofetal transfusion
Fetuses
Flow velocity
Genetic disorders
Heart
Infants (Newborn)
Laser surgery
Lasers in surgery
Neonates
Pregnancy
Pregnant women
Pulmonary arteries
Stenosis
Surgery
Survival
Transfusion
Twins
Ultrasonic imaging
Veins & arteries
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Summary:To assess the cardiac function and prevalence of congenital heart defects (CHD) in twin-twin transfusion syndrome (TTTS) survivors. Prospective follow-up of TTTS pregnancies treated with laser surgery (2015-2018). Echocardiography was performed 1 day and 1 month after birth (corrected for prematurity). Results were compared with a control group of age-matched uncomplicated monochorionic twin-pairs at 1 month. Eighty-nine TTTS (168 neonates) and nine control pregnancies (18 neonates) were enrolled. CHD birth prevalence was 9.2% (8/87) in recipients and 13.6% (11/81) in donors (p = 0.37). Four of 19 (21%) were detected prenatally, all pulmonary stenosis. Donors had lower aortic peak velocities compared with recipients at day 1 (0.66 ± 0.15 m/s vs 0.71 ± 0.19 m/s, p = 0.04) and 1 month (1.04 ± 0.21 m/s vs 1.11 ± 0.18 m/s, p = 0.02), but not compared with controls. CHD prevalence in TTTS survivors is high, with a low prenatal detection of minor abnormalities. Follow-up fetal echocardiograms and a postnatal echocardiogram should be offered.
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-020-0645-x