title: Evaluation of the measurement of the middle cerebral artery peak systolic velocity before and after placental laser coagulation in twin-to-twin transfusion syndrome.
abstract: OBJECTIVE
  The aim of this study is to evaluate the incidence of elevated middle cerebral artery peak systolic velocity (MCA-PSV) in twin-to-twin transfusion syndrome (TTTS) before and after laser and its predictive value for intrauterine fetal death (IUFD) occurring within 2 to 7 days following laser.
  
  
  METHODS
  This is a 5-year retrospective single-center study on 86 consecutive laser procedures for TTTS. MCA-PSV was measured prior to and 48 h following laser. We correlated perioperative MCA-PSV and fetal survival within 7 days following laser.
  
  
  RESULTS
  The incidence of elevated MCA-PSV prior to and following laser (NS) was 8.2% to 9.7% (non significant (NS)). There was no correlation between the incidence of an elevated MCA-PSV prior to laser and fetal survival up to 7 days after laser (NS, χ(2) :3.49). In contrast, the presence of an MCA-PSV above 1.5 MoM 48 h following laser in the former donor puts the former donor at a higher risk for IUFD within a week after surgery [odds ratio (OR):3.42 (interval of confidence (IC) 95%:1.9-30.6), χ(2) :8.68, p < 0.003].
  
  
  CONCLUSIONS
  The occurrence of an elevated MCA-PSV following laser is related to postoperative donor death within 2 to 7 days after laser.
authors.affiliation: Fetal Diagnosis and Medicine, CMCO, Schiltigheim, France. ngoc-tu.trieu@laposte.net
authors.forename: Ngoc-Tu
authors.initials: NT
authors.lastname: Trieu
authors.forename: A S
authors.initials: AS
authors.lastname: Weingertner
authors.forename: F
authors.initials: F
authors.lastname: Guerra
authors.forename: D
authors.initials: D
authors.lastname: Dautun
authors.forename: M
authors.initials: M
authors.lastname: Kohler
authors.forename: C
authors.initials: C
authors.lastname: Vayssière
authors.forename: I
authors.initials: I
authors.lastname: Nisand
authors.forename: R
authors.initials: R
authors.lastname: Favre
mesh_terms: D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D002560:Cerebrovascular Circulation; D005260:Female; D005313:Fetal Death; D005330:Fetofetal Transfusion / Q000401:mortality / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D017075:Laser Coagulation; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D010920:Placenta / Q000098:blood supply; D011183:Postoperative Complications; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D013599:Systole / Q000502:physiology; D014430:Twins, Monozygotic; D014463:Ultrasonography; D055815:Young Adult