Fetal and neonatal echocardiographic findings in twin-twin transfusion syndrome.
OBJECTIVE
The study's aim was to analyze the type of cardiac involvement in fetuses or infants with twin-twin transfusion syndrome.


METHODS
Seventeen pairs of monochorionic diamniotic twin fetuses with twin-twin transfusion syndrome underwent serial Doppler echocardiographic studies. Repeated decompressive amniocenteses were performed in all pregnancies.


RESULTS
No specific cardiac involvement was seen in donor twins in utero or after birth. All recipient twin fetuses showed variable degrees of biventricular hypertrophy and dilation with tricuspid regurgitation. These features were also evident in 45% of the recipient twin neonates. The fluid unbalance resolved with serial amniocenteses in 9 cases and in a further 2 after the death of the donor twin; in all 11 of these recipient twin fetuses there was some degree of improvement of the cardiac involvement, which became normal in all surviving recipient twin infants within 40 days to 6 months after birth.


CONCLUSIONS
Features of cardiac hypertrophy with signs of a prehydropic or hydropic state develop during fetal life in recipient twins in twin-twin transfusion syndrome; this impairment is reversible with the resolution of the fluid imbalance or after delivery.
Fesslova
V
V
Department of Cardiology, Istituti Clinici di Perfezionamento, Milan, Italy.
Villa
L
L
Nava
S
S
Mosca
F
F
Nicolini
U
U
D004200:Diseases in Twins; D004452:Echocardiography; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging / Q000473:pathology; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology; D017380:Hypertrophy, Right Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology; D007231:Infant, Newborn; D011247:Pregnancy