Abstract
Objective
To assess the cardiac function and prevalence of congenital heart defects (CHD) in twin–twin transfusion syndrome (TTTS) survivors.
Study design
Prospective follow-up of TTTS pregnancies treated with laser surgery (2015–2018). Echocardiography was performed 1 day and 1 month after birth (corrected for prematurity). Results were compared with a control group of age-matched uncomplicated monochorionic twin-pairs at 1 month.
Result
Eighty-nine TTTS (168 neonates) and nine control pregnancies (18 neonates) were enrolled. CHD birth prevalence was 9.2% (8/87) in recipients and 13.6% (11/81) in donors (p = 0.37). Four of 19 (21%) were detected prenatally, all pulmonary stenosis. Donors had lower aortic peak velocities compared with recipients at day 1 (0.66 ± 0.15 m/s vs 0.71 ± 0.19 m/s, p = 0.04) and 1 month (1.04 ± 0.21 m/s vs 1.11 ± 0.18 m/s, p = 0.02), but not compared with controls.
Conclusion
CHD prevalence in TTTS survivors is high, with a low prenatal detection of minor abnormalities. Follow-up fetal echocardiograms and a postnatal echocardiogram should be offered.
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Acknowledgements
We thank the parents of all twins who participated in this study. We also would like to thank those involved with the planning and performance of the postnatal echocardiograms. We want to pay special thanks to Fransisca de Klerk Voll and Gwen Timmermans Bos.
Funding
This study is funded by Canon Medical Systems Corporation, Otawara, Tochigi, Japan.
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Study conception and design: SJE, MCH, and ADJTH, data acquisition: all authors, analysis and data interpretation: MG and ADJTH, drafting of the manuscript: MG, critical revision: all authors.
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The study was approved by the medical ethical committee of the Leiden University Medical Center (NL 45251.058.13).
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Gijtenbeek, M., Haak, M.C., Eschbach, S.J. et al. Early postnatal cardiac follow-up of survivors of twin–twin transfusion syndrome treated with fetoscopic laser coagulation. J Perinatol 40, 1375–1382 (2020). https://doi.org/10.1038/s41372-020-0645-x
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DOI: https://doi.org/10.1038/s41372-020-0645-x