Alterations in fetal Doppler parameters before and twenty-four hours after radiofrequency ablation for twin reversed arterial perfusion sequence

Zhang, Lan, Liu, Hongli, Huang, Shuai, Tong, Chao, Wang, Zhigang, Qi, Hongbo, Baker, Philip N. and Kilby, Mark D. (2022) Alterations in fetal Doppler parameters before and twenty-four hours after radiofrequency ablation for twin reversed arterial perfusion sequence. Frontiers in Medicine, 9. ISSN 2296-858X

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Abstract

Objective: To evaluate alterations in the fetal Doppler parameters of pump fetuses before and 24 h after radiofrequency ablation surgery for twin reversed arterial perfusion sequence (TRAPs). Methods: This is a retrospective study of 28 pump fetuses in TRAPs and 28 normal control twins between 2016 and 2021. The fetal Doppler parameters, including the umbilical artery pulsatility index (UA-PI), middle cerebral artery peak systolic velocity (MCA-PSV), middle cerebral artery pulsatility index (MCA-PI), and cerebroplacental ratio (CPR), of the controls, and pump fetuses before and 24 h after surgery were compared. Results: An increasing trend and a further increase in the MCA-PSV, MCA-PI, MCA-PSV Z score, and MCA-PI Z score after surgery were observed in pump fetuses with gestational age (GA) ≥20 weeks; however, such changes were not observed in those with a GA of <20 weeks. The UA-PI and CPR before and after surgery were not different between control and pump fetuses, whether the GA was ≥20 or <20 weeks. Conclusion: In the middle second trimester, the pump fetus might suffer from high cardiac output rather than hypoxemia before surgery and congestive heart failure, or hemodilutional anemia after surgery. This may provide some theoretical evidence in favor of early intervention, rather than waiting for a more advanced GA, to avoid unnecessary hemodynamic alterations.

Item Type:	Article
Additional Information:	Data Availability Statement: The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. Funding Information: This study was funded by the National Natural Science Foundation of China (U21A20346, 82171662, and 82001580), Chongqing Science and Technology Commission (cstc2021ycjh-bgzxm0192), Chongqing Health Committee (2019GDRC012 and 2021MSXM193), and Chongqing Education Committee (KJZD-K202100404).
Uncontrolled Keywords:	doppler,middle cerebral artery,monochorionic twin,radiofrequency ablation,twin reversed artery perfusion sequence,umbilical artery,medicine(all) ,/dk/atira/pure/subjectarea/asjc/2700
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	07 May 2025 15:30
Last Modified:	11 May 2025 00:07
URI:	https://ueaeprints.uea.ac.uk/id/eprint/99200
DOI:	10.3389/fmed.2022.802666

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