Predictive value of cardiovascular parameters in stages 1 and 2 of twin-to-twin transfusion syndrome

ObjectiveThe Quintero staging of twin-to-twin transfusion syndrome (TTTS) does not include a comprehensive cardiovascular assessment. The aim of this study is to assess the predictive value of the myocardial performance index (MPI) and the Children's Hospital of Philadelphia (CHOP) score on recipient survival in Quintero stages 1 and 2 TTTS. MethodsThe cohort study was based on prospectively collected data between May 2008 and February 2013 in a population of stages 1 and 2 TTTS. Comparisons between groups were carried out using Student's t-test and (2)-test. A stepwise ascending multivariate logistic regression model was then built. ResultsA total of 73 pregnancies in stages 1 and 2 of Quintero's classification were treated with laser. Rates of recipient fetal losses were higher when MPI was above 0.43ms (71.4% vs 28.6%, p=0.022). Rate of CHOP score above 5 was higher in the fetal loss group (28.6% vs 5.1%, p=0.022). After adjustment for Quintero stages 1 or 2, the risk of recipient loss rate is higher according to CHOP score [OR 7.6; 95% confidence interval (CI) 1.3-43.5] or MPI value (OR 3.7; 95% CI 1.0-13.9). ConclusionThe CHOP score and MPI are correlated with the recipient survival in stages 1 and 2 TTTS. (c) 2014 John Wiley & Sons, Ltd.