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Evaluation of cardiac performance by abdominal fetal ECG in twin-to-twin transfusion syndrome.

Abstract

OBJECTIVE
To investigate fetal cardiac performance by abdominal fetal electrocardiography (ECG) in monochorionic diamniotic pregnancies with twin-to-twin transfusion syndrome (TTTS-MCDA).
METHODS
Abdominal fetal ECG was attempted in 16 singleton, 21 non-TTTS-MCDA, and 14 TTTS-MCDA pregnancies at 16-27 weeks' gestation. Standard ECG parameters were compared across study groups and evaluated for their correlation with Doppler ultrasound indices.
RESULTS
Clear P-QRST complexes were recognized in all cases. In the TTTS-MCDA pregnancies, the QT interval and QTc were significantly longer than in both singletons and the non-TTTS-MCDA pregnancies (p = 0.002 and p = 0.0002, respectively), whereas in the recipient fetus, both the PR interval and PR/RR were significantly longer when compared with all other study groups (p = 0.019 and p = 0.012, respectively). Further comparison with Doppler ultrasound indices yielded significant reciprocal correlations between ductus venosus pulsatility index and the QT interval (r = 0.552, p = 0.041) and between umbilical artery pulsatility index and PR/RR (r = 0.654, p = 0.011) both demonstrated in recipient fetuses alone.
CONCLUSIONS
Abdominal fetal ECG is feasible in second-trimester twin pregnancies. In TTTS, there is evidence of a higher risk of cardiac dysfunction in the recipient twin.

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  • Publisher Full Text

    • Authors

    Velayo C, Calvo JR, Sato N, Kimura Y, Yaegashi N, Nicolaides K

    Institution

    Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, Denmark Hill, London, UK. chinkeyvelayo@med.tohoku.ac.jp

    Source

    Prenatal diagnosis 32:11 2012 Nov pg 1059-65

    MeSH

    Abdomen
    Adult
    Cardiotocography
    Echocardiography, Doppler
    Electrocardiography
    Feasibility Studies
    Female
    Fetal Diseases
    Fetofetal Transfusion
    Gestational Age
    Heart
    Heart Rate, Fetal
    Humans
    Pregnancy
    Pregnancy Trimester, Second
    Prenatal Diagnosis
    Tertiary Care Centers
    Twins, Monozygotic

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Twin Study

    Language

    eng

    PubMed ID

    22886606