Initial Fetal Cardiovascular Profile Score Predicts Recipient Twin Outcome in Twin-Twin Transfusion Syndrome

Amy Shah D Lay, William L. Border, Timothy M. Crombleholme, Erik C. Michelfelder*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

72 Scopus citations

Abstract

Background: The aim of this study was to assess the relationship between cardiomyopathy and recipient twin (RT) outcome in twin-twin transfusion syndrome (TTTS). Methods: Fetal echocardiography and outcomes data in 62 consecutive pregnancies with TTTS were reviewed. The primary outcome was neonatal RT survival. The severity of RT cardiomyopathy at presentation was assessed by the cardiovascular profile score (CVPS). RT outcomes and odds of survival were compared between groups stratified by CVPS. Results: Overall neonatal survival for all fetuses was 61% (76 of 124). RT survival was 58% (36 of 62). Grouped by CVPS, RT survival was greater (50%) for those with CVPS ≥ 9 and even higher (74%) for CVPS of 10. Among the components of the CVPS, atrioventricular valve regurgitation was associated with negative RT outcome. Other factors at presentation were not predictive of RT outcome. Conclusions: A normal CVPS in the RT in TTTS is predictive of improved survival compared with an abnormal CVPS, even in RTs with minor deductions. Standard clinical staging did not predict outcome. Cardiac assessment by CVPS may improve clinical decision making and the timing of fetal interventions.

Original languageEnglish (US)
Pages (from-to)1105-1108
Number of pages4
JournalJournal of the American Society of Echocardiography
Volume21
Issue number10
DOIs
StatePublished - Oct 2008

Keywords

  • Fetal cardiovascular profile score
  • Fetal echocardiography
  • Twin-twin transfusion syndrome

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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