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Early postnatal cardiac follow-up of survivors of twin–twin transfusion syndrome treated with fetoscopic laser coagulation

Journal of Perinatology volume 40, pages 1375–1382 (2020)Cite this article

Subjects

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.

Author information

Authors and Affiliations

  1. Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands

    Manon Gijtenbeek, Monique C. Haak, Sanne J. Eschbach, Zoë A. Buijnsters, Johanna M. Middeldorp, Frans J.C.M. Klumper & Dick Oepkes

  2. Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands

    Arend D. J. ten Harkel

Authors
  1. Manon Gijtenbeek
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  2. Monique C. Haak
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  3. Sanne J. Eschbach
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  4. Zoë A. Buijnsters
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  5. Johanna M. Middeldorp
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  6. Frans J.C.M. Klumper
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  7. Dick Oepkes
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  8. Arend D. J. ten Harkel
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Contributions

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.

Corresponding author

Correspondence to Manon Gijtenbeek.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the medical ethical committee of the Leiden University Medical Center (NL 45251.058.13).

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Written informed consent was obtained from the parents.

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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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