OBJECTIVE: To examine effects of fetoscopic laser occlusion of placental vascular anastomoses on umbilical venous volume flow in twin-to-twin transfusion syndrome. STUDY DESIGN: Absolute umbilical venous volume flow, measured preoperatively and 48 hours after fetoscopic laser occlusion was related to Doppler studies, bladder filling in donors, and anastomoses. RESULTS: Among 45 patients, recipients had decreased ductus venosus pulsatility index (ductus venosus-pulsatility index for veins, 1.16 vs 1.01; P < .001) and unchanged umbilical venous volume flow after fetoscopic laser occlusion (74.7 vs 74.5 mL; P = .407). Donors had decreased umbilical artery pulsatility (1.34 vs 1.11; P = .008), increased ductus venous-pulsatility index for veins (0.75 vs 0.91; P < .014), and significantly increased umbilical venous volume flow per kilogram by 52.3% (136.6 vs 208.0 mL/Kg/min; P < .001). Donor bladder filling occured at higher umbilical venous volume flow per kilogram (142.7 vs 221.4 mL/Kg/min; P < .012). Increase in umbilical venous volume flow per kilogram correlated with the net difference in arteriovenous anastomoses (Pearson r = 0.403, P = .006). CONCLUSION: Fetoscopic laser occlusion in twin-to-twin transfusion syndrome corrects intertwin differences in umbilical venous volume flow by predominant effects in the donor. Reappearance of donor bladder filling correlates with correction of volume flow.
机构:Univ Paris Ouest St Quentin en Yvelines, CHI Poissy St Germain en Laye, Serv Gynecol & Obstet, Poissy, France
Yamamoto, M.
Nasr, B.
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机构:Univ Paris Ouest St Quentin en Yvelines, CHI Poissy St Germain en Laye, Serv Gynecol & Obstet, Poissy, France
Nasr, B.
Ortqvist, L.
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机构:Univ Paris Ouest St Quentin en Yvelines, CHI Poissy St Germain en Laye, Serv Gynecol & Obstet, Poissy, France
Ortqvist, L.
Bernard, J. -P.
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机构:Univ Paris Ouest St Quentin en Yvelines, CHI Poissy St Germain en Laye, Serv Gynecol & Obstet, Poissy, France
Bernard, J. -P.
Takahashi, Y.
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机构:Univ Paris Ouest St Quentin en Yvelines, CHI Poissy St Germain en Laye, Serv Gynecol & Obstet, Poissy, France
Takahashi, Y.
Ville, Y.
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Univ Paris Ouest St Quentin en Yvelines, CHI Poissy St Germain en Laye, Serv Gynecol & Obstet, Poissy, FranceUniv Paris Ouest St Quentin en Yvelines, CHI Poissy St Germain en Laye, Serv Gynecol & Obstet, Poissy, France
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Istanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, TurkeyIstanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, Turkey
Has, Recep
Kalelioglu, Ibrahim
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Istanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, TurkeyIstanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, Turkey
Kalelioglu, Ibrahim
Esmer, Aytul Corbacioglu
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Istanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, TurkeyIstanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, Turkey
Esmer, Aytul Corbacioglu
Ermis, Hayri
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Istanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, TurkeyIstanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, Turkey
Ermis, Hayri
Dural, Ozlem
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Istanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, TurkeyIstanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, Turkey
Dural, Ozlem
Dogan, Yasemin
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Istanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, TurkeyIstanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, Turkey
Dogan, Yasemin
Yasa, Cenk
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Istanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, TurkeyIstanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, Turkey
Yasa, Cenk
Yumru, Harika
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Istanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, TurkeyIstanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, Turkey
Yumru, Harika
Demir, Omer
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Istanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, TurkeyIstanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, Turkey
Demir, Omer
Yuksel, Atil
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Istanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, TurkeyIstanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, Turkey
Yuksel, Atil
Ibrahimoglu, Lemi
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Istanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, TurkeyIstanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, Turkey
Ibrahimoglu, Lemi
Yildirim, Alkan
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Istanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, TurkeyIstanbul Univ, Istanbul Fac Med, Dept Obstet & Gynecol, TR-34093 Fatih Istanbul, Turkey