Fetal arterial Doppler studies in twin‐twin transfusion syndrome.

This cross‐sectional study investigates the circulatory profile of the donor and recipient fetuses in pregnancies with twin‐twin transfusion syndrome manifested by acute polyhydramnios during the second trimester of pregnancy. Doppler investigations of the umbilical arteries and of the fetal descending thoracic aortas and middle cerebral arteries were performed in both fetuses of 27 pregnancies with twin‐twin transfusion syndrome at 18 to 25 (mean, 21.7) weeks' gestation. Significant differences from normal values were increased umbilical artery pulsatility index and decreased aortic mean velocity in both donor and recipient fetuses, decreased middle cerebral artery pulsatility index in recipients and decreased middle cerebral artery mean velocity in donors. Increased umbilical artery pulsatility index in some donor and recipient fetuses may be the consequence of abnormal placental development and polyhydramnios‐related compression, respectively. Doppler findings in the fetal circulation are compatible with hypovolemia in the donor and hypervolemia with congestive heart failure in the recipient.

[1]  W. Giles,et al.  Doppler Umbilical Artery Studies in the Twin-Twin Transfusion Syndrome , 1990, Obstetrics and gynecology.

[2]  K. Nicolaides,et al.  Prediction of fetal anemia by measurement of the mean blood velocity in the fetal aorta. , 1990, American journal of obstetrics and gynecology.

[3]  K. Nicolaides,et al.  Doppler Studies in Red Cell Isoimmunization , 1989, Clinical obstetrics and gynecology.

[4]  S. Mizutani,et al.  Antenatal Diagnosis of Twin-Twin Transfusion Syndrome by Doppler Ultrasound , 1991, Obstetrics and gynecology.

[5]  R. Goldstein,et al.  The Role of Velamentous Cord Insertion in the Etiology of Twin-Twin Transfusion Syndrome , 1993, Obstetrics and gynecology.

[6]  K. Nicolaides,et al.  Doppler examination of the middle cerebral artery in anemic fetuses. , 1990, American journal of obstetrics and gynecology.

[7]  F. P. Hadlock,et al.  Estimation of fetal weight with the use of head, body, and femur measurements--a prospective study. , 1985, American journal of obstetrics and gynecology.

[8]  K. Nicolaides,et al.  Therapeutic amniocentesis in twin-twin transfusion syndrome appearing in the second trimester of pregnancy. , 1992, American journal of obstetrics and gynecology.

[9]  K. Nicolaides,et al.  Twin-twin transfusion syndrome during the 2nd trimester is associated with small intertwin hemoglobin differences. , 1991, Fetal diagnosis and therapy.

[10]  J. Green,et al.  Fetal cardiac output in the isoimmunized pregnancy: a pulsed Doppler-echocardiographic study of patients undergoing intravascular intrauterine transfusion. , 1989, American journal of obstetrics and gynecology.

[11]  K. Nicolaides,et al.  Middle cerebral artery flow velocity waveforms in fetal hypoxaemia , 1990, British journal of obstetrics and gynaecology.

[12]  G. Knox,et al.  Is pulsed Doppler velocimetry useful in the management of multiple-gestation pregnancies? , 1991, American journal of obstetrics and gynecology.

[13]  K. Nicolaides,et al.  Maternal abdominal pressure alters fetal cerebral blood flow. , 1991, British journal of obstetrics and gynaecology.

[14]  T. Nelson,et al.  Doppler ultrasound of twin transfusion syndrome. , 1988, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[15]  K. Nicolaides,et al.  Effects of intravascular fetal blood transfusion on fetal intracardiac Doppler velocity waveforms. , 1990, American journal of obstetrics and gynecology.