What is the definition of pulsatile umbilical venous flow in twin-twin transfusion syndrome?

Objective The aim of the study was to derive an objective definition of pulsatile umbilical venous flow (PUVF). Study Design Pulsed Doppler waveform analysis of the umbilical vein was performed in stages III and IV twin-twin transfusion syndrome (TTTS) patients. In patients with PUVF, the umbilical...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2008-01, Vol.199 (6), p.634.e1-634.e4
Main Authors: Russell, Zoi, MD, Quintero, Rubén A., MD, Kontopoulos, Eftichia V., MD
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cohort Studies
Female
Fetofetal Transfusion - diagnostic imaging
Fetofetal Transfusion - physiopathology
fetus
Gestational Age
Gynecology. Andrology. Obstetrics
Humans
Medical sciences
Obstetrics and Gynecology
Pregnancy
Pregnancy Outcome
Pregnancy, High-Risk
Pregnancy, Multiple
Probability
pulsatile
Pulsatile Flow - physiology
pulsatility
Quintero staging
resistance index
Retrospective Studies
Risk Assessment
Sensitivity and Specificity
Statistics, Nonparametric
Terminology as Topic
twin-twin transfusion syndrome
Twins, Monozygotic
Ultrasonography, Doppler, Pulsed
Ultrasonography, Prenatal
umbilical vein
Umbilical Veins - diagnostic imaging
Vascular Resistance - physiology
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Summary:Objective The aim of the study was to derive an objective definition of pulsatile umbilical venous flow (PUVF). Study Design Pulsed Doppler waveform analysis of the umbilical vein was performed in stages III and IV twin-twin transfusion syndrome (TTTS) patients. In patients with PUVF, the umbilical vein maximum (Vmax) and the umbilical vein minimum velocity (Vmin) and the resistance index for the umbilical vein (UVRI) = (100 × [Vmax − Vmin]/Vmax) were assessed. Results PUVF was noted in 130 of 226 stages III and IV TTTS patients. Digital images were available for analysis in 65 of 130 patients (50%). The minimum UVRI associated with PUVF was 16% for stages III and IV TTTS. There was a trend for increasing UVRI with stage ( P = .052). Stage IV patients were more likely to have an UVRI greater than 30% ( P = .02). Conclusion PUVF can be defined as an UVRI greater than 15%. A scale definition of PUVF may further facilitate assessment of the degree of fetal hemodynamic compromise.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2008.05.025