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Open Access 01-12-2021 | Research

Reference values for fetal Doppler-based cardiocirculatory indices in monochorionic-diamniotic twin pregnancy

Authors: Thananan Chongsomboonsuk, Nisarat Phithakwatchara, Katika Nawapun, Sommai Viboonchart, Suparat Jaingam, Tuangsit Wataganara

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

Abstract

Background

Placental anastomoses in monochorionic diamniotic (MCDA) twin pregnancy have a major impact on fetal circulation. This study was designed to define reference ranges of cardiac and vascular Doppler indices in MCDA twin pregnancies.

Methods

This cross-sectional study included 442 uncomplicated MCDA twin fetuses undergoing Doppler ultrasonography at 18–35 weeks of gestation. Left and right myocardial performance index (LV-MPI, RV-MPI), E/A ratio of atrioventricular valves, pulsatility indices of umbilical artery, middle cerebral artery (MCA), and ductus venosus (DV), cerebroplacental ratio, peak systolic velocity of MCA, S/a ratio of DV, and early diastolic filling time of ductus venosus (DV-E) were evaluated under standardized settings. The equation models between Doppler indices and gestational age (GA) were fitted. After adjustment for GA, the correlations between MPI and fetal heart rate (FHR), and between MPI and DV indices were analyzed.

Results

Estimated centiles of Doppler indices were derived as a function of GA, being distinct in values from those of singletons. There was no correlation between GA-adjusted MPI and FHR. DV-E was inversely related to LV-MPI.

Conclusions

MCDA twins showed significant changes in some Doppler indices throughout gestation with quantitative differences from singletons, emphasizing the importance of MC twin-specific reference values for clinical application. Further adjustment of MPI for FHR was unnecessary. DV-E is a vascular index indirectly representing fetal diastolic function.

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Title: Reference values for fetal Doppler-based cardiocirculatory indices in monochorionic-diamniotic twin pregnancy
Authors: Thananan Chongsomboonsuk
Nisarat Phithakwatchara
Katika Nawapun
Sommai Viboonchart
Suparat Jaingam
Tuangsit Wataganara
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-021-04255-w

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Springer Medicine

Reference values for fetal Doppler-based cardiocirculatory indices in monochorionic-diamniotic twin pregnancy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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