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Prediction of Twin-to-Twin Transfusion Syndrome Using Characteristic Waveforms of Ductus Venosus in Recipient Twins
Twin Research and Human Genetics ( IF 0.9 ) Pub Date : 2020-10-02 , DOI: 10.1017/thg.2020.73
Mayumi Takano 1, 2 , Masahiko Nakata 1, 2, 3 , Sumito Nagasaki 1, 2 , Junya Sakuma 2, 3 , Mineto Morita 1, 2, 3
Affiliation  

We aimed to investigate whether the alterations of time intervals and velocity–time integrals (VTIs) of ductus venosus (DV) Doppler flow could predict evolving twin-to-twin transfusion syndrome (TTTS) in monochorionic diamniotic (MD) twin pregnancies in the second trimester. DV Doppler waveforms of MD twin pregnancies were retrospectively analyzed. Time intervals and VTIs of the accelerating phase of S-wave (S1 and VTI-1), decelerating phase of S-wave (S2 and VTI-2) and phase of D-wave (D and VTI-diast) were measured in the recipient twins of TTTS and the larger twins of uncomplicated MD twins. Each parameter was normalized to total time intervals and VTIs. DV parameters of prerecipient twins in pre-TTTS conditions were analyzed. The pre-TTTS condition was defined as the condition within 2 weeks before when TTTS cases fulfilled the criteria. Both recipient twins in TTTS cases and prerecipient twins in pre-TTTS condition showed significantly shorter S1, longer S2, shorter D, smaller VTI-1, larger VTI-2 and smaller VTI-diast than did the larger twins in uncomplicated MD twins (p < .05). Receiver-operating characteristic curve analysis showed that VTI-2 had better performance, and VTI-2 >45.5% had 87.0% sensitivity, 90.9% specificity, 81.0% positive predictive value and 93.0% negative predictive value for detecting prerecipient twins. Recipient twins complicated with TTTS have characteristic alterations in time intervals and VTIs of DV Doppler flow, which is present even before fulfilling the TTTS criteria. Furthermore, VTI-2 >45.5% is a possible predictive parameter for TTTS in the second trimester.

中文翻译:

使用双胞胎静脉导管特征波形预测双胞胎输血综合征

我们旨在调查静脉导管 (DV) 多普勒血流的时间间隔和速度-时间积分 (VTI) 的变化是否可以预测单绒毛膜双羊膜 (MD) 双胎妊娠中双胎输血综合征 (TTTS) 的发展。三个月。回顾性分析了MD双胎妊娠的DV多普勒波形。测量了 S 波加速期(S1 和 VTI-1)、S 波减速期(S2 和 VTI-2)和 D 波相位(D 和 VTI-diast)的时间间隔和 VTI。 TTTS 的接受双胞胎和简单的 MD 双胞胎的较大双胞胎。每个参数都标准化为总时间间隔和 VTI。分析了在 TTTS 前条件下的预受者双胞胎的 DV 参数。TTTS 前条件定义为 TTTS 病例符合标准前 2 周内的条件。p< .05)。接受者操作特征曲线分析显示,VTI-2 具有更好的性能,VTI-2 >45.5% 对检测先行双胞胎的敏感性为 87.0%,特异性为 90.9%,阳性预测值为 81.0%,阴性预测值为 93.0%。患有 TTTS 的受者双胞胎在 DV 多普勒血流的时间间隔和 VTI 方面具有特征性改变,这种改变甚至在满足 TTTS 标准之前就已经存在。此外,VTI-2 >45.5% 可能是妊娠中期 TTTS 的预测参数。
更新日期:2020-10-02
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