Changes in the recipient fetal Tei index in the peri-operative period after laser photocoagulation of placental anastomoses for twin-twin transfusion syndrome.
OBJECTIVE
To assess serial changes in the Tei index of the recipient fetus secondary to fetoscopic laser photocoagulation of placental anastomoses (FLP) for twin-twin transfusion syndrome (TTTS) during the peri-operative period.


METHODS
A prospective study of cases that underwent FLP at the Texas Children's Fetal Center was performed. Mean and individual changes in the Tei index measurements were obtained during the pre-operative, intra-operative and the post-operative (12-h and 24-h) periods after surgery and were compared using paired t-test. A p-value of < 0.05 was considered as significant.


RESULTS
A total of 20 patients were included in the study. In both the right and the left side, the mean Tei indices appeared to be increased from baseline during the intra-operative period, with a subsequent decrease to pre-operative values within 24 h of laser surgery. These changes were also noted when individualized patient results were analyzed in a serial fashion.


CONCLUSIONS
FLP results in a transient increase in the intra-operative myocardial performance index in the recipient fetus. These changes appear to resolve in the post-operative period.
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine and the Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA. rpapanna@gmail.com
Ramesha
R
Papanna
Lovepreet K
LK
Mann
Saulo
S
Molina
Anthony
A
Johnson
Kenneth J
KJ
Moise
D005260:Female; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging / Q000601:surgery; D005332:Fetoscopy; D005333:Fetus / Q000601:surgery; D006801:Humans; D017075:Laser Coagulation; D019990:Perioperative Care; D010920:Placenta / Q000098:blood supply / Q000601:surgery*; D011247:Pregnancy; D016216:Ultrasonography, Prenatal