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Fetal middle cerebral artery Doppler fluctuations after laser surgery for twin–twin transfusion syndrome

Journal of Perinatology volume 31, pages 368–372 (2011)Cite this article

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Abstract

Objective:

The objective of this study was to compare alterations in the middle cerebral artery (MCA) pulsatility index (PI) and mean velocity (Vmean) after laser surgery for twin–twin transfusion syndrome (TTTS).

Study Design:

MCA Doppler studies were conducted 1 day before and after laser surgery for TTTS. The pre- and postoperative mean (standard deviation) of the MCA PI and Vmean z-scores of the recipient and donor fetuses were calculated and compared. Data were analyzed using paired testing and multivariable linear regression models.

Results:

A total of 103 patients met the study criteria. Recipients’ MCA PI increased from −1.29 (1.20) preoperatively to 0.14 (1.52) postoperatively (P<0.0001), whereas the donors’ PI did not change significantly (−0.31 (1.67) to −0.67 (1.29); P=0.12). There was no significant difference between preoperative and postoperative MCA Vmean in donors (0.39 (0.83) and 0.38 (0.93), respectively; P=0.5048) or recipients (0.60 (0.74) and 0.63 (0.90), respectively; P=0.5324).

Conclusions:

Despite the changes in the MCA PI after laser surgery for TTTS, the MCA Vmean remained constant. These findings may suggest some autoregulatory capacity in the cerebral vessels of the mid-trimester fetus.

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Acknowledgements

We thank Dr Amer Khan for his assistance with data collection, and Dr Istvan Seri and Dr Shehab Noori for their assistance in the conception of the study. There was no outside funding or technical assistance with the production of this article.

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Authors and Affiliations

  1. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University Southern California, Los Angeles, CA, USA

    P Aghajanian, S A Assaf, L M Korst, D A Miller & R H Chmait

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  1. P Aghajanian
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  2. S A Assaf
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  3. L M Korst
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  4. D A Miller
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  5. R H Chmait
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Correspondence to R H Chmait.

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The authors declare no conflict of interest.

Additional information

Results from this manuscript were presented as Abstract no 399 at Poster Session III, at the Society for Maternal-Fetal Medicine, 30th Annual Meeting, Chicago, IL, USA on 5 February 2010

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Aghajanian, P., Assaf, S., Korst, L. et al. Fetal middle cerebral artery Doppler fluctuations after laser surgery for twin–twin transfusion syndrome. J Perinatol 31, 368–372 (2011). https://doi.org/10.1038/jp.2010.133

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