Objective

To assess the cardiac function and prevalence of congenital heart defects (CHD) in twin–twin transfusion syndrome (TTTS) survivors.

Study design

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.

Result

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.

Conclusion

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.

中文翻译：

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胎儿镜激光凝固治疗双胞胎输血综合征幸存者的产后早期心脏随访。

客观的

评估双胞胎输血综合征 (TTTS) 幸存者的心脏功能和先天性心脏缺陷 (CHD) 的患病率。

学习规划

激光手术治疗 TTTS 妊娠的前瞻性随访（2015-2018）。在出生后 1 天和 1 个月进行超声心动图检查（校正早产）。在 1 个月时将结果与年龄匹配的无并发症单绒毛膜双胞胎的对照组进行比较。

结果

89 名 TTTS（168 名新生儿）和 9 名对照妊娠（18 名新生儿）入选。CHD 出生率在接受者中为 9.2% (8/87)，在捐赠者中为 13.6% (11/81) ( p  = 0.37)。19 例中有 4 例 (21%) 在产前被检测到，均为肺动脉狭窄。在第 1 天（0.66 ± 0.15 m/s vs 0.71 ± 0.19 m/s，p  = 0.04）和第 1 个月（1.04 ± 0.21 m/s vs 1.11 ± 0.18 m/s，p），捐献者的主动脉峰值速度低于接受者 = 0.02)，但未与对照进行比较。

结论

TTTS 幸存者的 CHD 患病率很高，产前对轻微异常的检测率很低。应提供后续胎儿超声心动图和产后超声心动图。