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- Title
Fetal hypertension: an insight into the pathogenesis of the twintwin transfusion syndrome.
- Authors
D. Mahieu-Caputo; L. J. Salomon; J. Le Bidois; L. Fermont; A. Brunhes; P. Jouvet; Y. Dumez; M. Dommergues
- Abstract
To investigate if systemic hypertension occurs in fetuses with twin-to-twin transfusion syndrome (TTTS). We conducted an observational cohort study in a tertiary care centre in 23 pregnant women with TTTS. Polyhydramnios stuck twin sequence occurred at a median gestational age of 22 weeks (range 1527). Biventricular myocardial hypertrophy was diagnosed in 22/23 recipient fetuses. In cases with atrioventricular valve regurgitation (AVR), it was possible to estimate the fetal systolic systemic blood pressure by ultrasound, on the basis of the simplified Bernouilli equation. The diagnosis of fetal hypertension (FHT) was made when the estimated systolic arterial pressure was equal to or above 1.6-fold the expected value. In 10 pregnancies (group A), fetal blood pressure could be assessed in recipients with AVR. The maximum velocities ranged from 2.9 to 5 m/s, leading to estimates of systemic fetal arterial pressure from 37 to 104 mmHg, that is, 1.6- to 2.8-fold the expected values. In 13 pregnancies (group B), fetal blood pressure could not be assessed in the absence of AVR. In group A, perinatal death (16/20) and hydrops (7/20) were significantly more frequent than in group B (8/26 and 1/26 respectively). Fetal systemic hypertension may occur in recipient twins and could play a role in the pathophysiology of TTTS. Copyright © 2003 John Wiley & Sons, Ltd.
- Subjects
PEDIATRIC cardiology; FETAL diseases; DISEASES in twins; CARDIAC hypertrophy; BLOOD pressure; CORD blood
- Publication
Prenatal Diagnosis, 2003, Vol 23, Issue 8, p640
- ISSN
0197-3851
- Publication type
Article
- DOI
10.1002/pd.652