Predictive value of cardiovascular parameters in stages 1 and 2 of twin-to-twin transfusion syndrome.
OBJECTIVE
The Quintero staging of twin-to-twin transfusion syndrome (TTTS) does not include a comprehensive cardiovascular assessment. The aim of this study is to assess the predictive value of the myocardial performance index (MPI) and the Children's Hospital of Philadelphia (CHOP) score on recipient survival in Quintero stages 1 and 2 TTTS.


METHODS
The cohort study was based on prospectively collected data between May 2008 and February 2013 in a population of stages 1 and 2 TTTS. Comparisons between groups were carried out using Student's t-test and χ(2)-test. A stepwise ascending multivariate logistic regression model was then built.


RESULTS
A total of 73 pregnancies in stages 1 and 2 of Quintero's classification were treated with laser. Rates of recipient fetal losses were higher when MPI was above 0.43 ms (71.4% vs 28.6%, p = 0.022). Rate of CHOP score above 5 was higher in the fetal loss group (28.6% vs 5.1%, p = 0.022). After adjustment for Quintero stages 1 or 2, the risk of recipient loss rate is higher according to CHOP score [OR 7.6; 95% confidence interval (CI) 1.3-43.5] or MPI value (OR 3.7; 95% CI 1.0-13.9).


CONCLUSIONS
The CHOP score and MPI are correlated with the recipient survival in stages 1 and 2 TTTS.
Department of Obstetrics and Gynaecology, Strasbourg University Teaching Hospital, Strasbourg, France.
Elodie
E
Gapp-Born
Nicolas
N
Sananes
Fernando
F
Guerra
Monique
M
Kohler
Anne Sophie
AS
Weingertner
Gabrielle
G
Fritz
Brigitte
B
Viville
Bruno
B
Langer
Erik
E
Sauleau
Israël
I
Nisand
Romain
R
Favre
D000328:Adult; D003661:Decision Support Techniques; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D005330:Fetofetal Transfusion / Q000175:diagnosis* / Q000401:mortality; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment