Ultrasound assessment prior to laser photocoagulation for twin-twin transfusion syndrome for predicting intrauterine fetal demise after surgery in Japanese patients.
OBJECTIVE
To evaluate the use of ultrasound before selective laser photocoagulation of communicating vessels (SLPCV) for twin-twin transfusion syndrome in predicting intrauterine fetal demise (IUFD).


METHODS
Fifty-five patients underwent SLPCV in Japan. Fetal biometry and Doppler studies of the umbilical artery, ductus venosus, and umbilical vein were performed prior to SLPCV. The visualization of the bladder and hydrops was recorded. Association between the parameters and IUFD was analyzed using multiple logistic regression analysis. The study was approved by the Institutional Review Board and patients gave their informed consent.


RESULTS
The IUFD incidence was 25.5% (14/55) in the donors and 12.7% (7/55) in the recipients. Twelve donors and 4 recipients of them ended in unexplainable IUFD. In the analysis of 53 donors, absent or reversed end-diastolic flow of umbilical artery (UAAREDF) was only associated with IUFD (p = 0.016). No parameters could predict IUFD in 52 recipients.


CONCLUSIONS
UAAREDF may be useful for predicting IUFD of the donor after SLPCV.
Ishii
Keisuke
K
Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. keisui@sis.seirei.or.jp
Hayashi
Satoshi
S
Nakata
Masahiko
M
Murakoshi
Takeshi
T
Sago
Haruhiko
H
Tanaka
Kenichi
K
D044466:Asian People / Q000706:statistics & numerical data*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D017075:Laser Coagulation; D016015:Logistic Models; D011237:Predictive Value of Tests; D011247:Pregnancy; D012720:Severity of Illness Index; D013577:Syndrome; D014427:Twins; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging