Alterations in fetal Doppler parameters before and twenty-four hours after radiofrequency ablation for twin reversed arterial perfusion sequence (2025)

Zhang, L., Liu, H., Huang, S., Tong, C., Wang, Z., Qi, H., Baker, P. N., & Kilby, M. 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, Article 802666. https://doi.org/10.3389/fmed.2022.802666

Zhang, Lan ; Liu, Hongli ; Huang, Shuai et al. / Alterations in fetal Doppler parameters before and twenty-four hours after radiofrequency ablation for twin reversed arterial perfusion sequence. In: Frontiers in Medicine. 2022 ; Vol. 9.

@article{11ad80f605a046edbe8e2367c1300282,

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

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.",

keywords = "doppler, middle cerebral artery, monochorionic twin, radiofrequency ablation, twin reversed artery perfusion sequence, umbilical artery",

author = "Lan Zhang and Hongli Liu and Shuai Huang and Chao Tong and Zhigang Wang and Hongbo Qi and Baker, {Philip N.} and Kilby, {Mark D.}",

note = "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).",

year = "2022",

month = apr,

day = "14",

doi = "10.3389/fmed.2022.802666",

language = "English",

volume = "9",

journal = "Frontiers in Medicine",

issn = "2296-858X",

publisher = "Frontiers Media S.A.",

}

Zhang, L, Liu, H, Huang, S, Tong, C, Wang, Z, Qi, H, Baker, PN & Kilby, MD 2022, 'Alterations in fetal Doppler parameters before and twenty-four hours after radiofrequency ablation for twin reversed arterial perfusion sequence', Frontiers in Medicine, vol. 9, 802666. https://doi.org/10.3389/fmed.2022.802666

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 et al.
In: Frontiers in Medicine, Vol. 9, 802666, 14.04.2022.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Alterations in fetal Doppler parameters before and twenty-four hours after radiofrequency ablation for twin reversed arterial perfusion sequence

AU - Zhang, Lan

AU - Liu, Hongli

AU - Huang, Shuai

AU - Tong, Chao

AU - Wang, Zhigang

AU - Qi, Hongbo

AU - Baker, Philip N.

AU - Kilby, Mark D.

N1 - 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).

PY - 2022/4/14

Y1 - 2022/4/14

N2 - 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.

AB - 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.

KW - doppler

KW - middle cerebral artery

KW - monochorionic twin

KW - radiofrequency ablation

KW - twin reversed artery perfusion sequence

KW - umbilical artery

UR - http://www.scopus.com/inward/record.url?scp=85128902484&partnerID=8YFLogxK

U2 - 10.3389/fmed.2022.802666

DO - 10.3389/fmed.2022.802666

M3 - Article

AN - SCOPUS:85128902484

SN - 2296-858X

VL - 9

JO - Frontiers in Medicine

JF - Frontiers in Medicine

M1 - 802666

ER -

Zhang L, Liu H, Huang S, Tong C, Wang Z, Qi H et al. Alterations in fetal Doppler parameters before and twenty-four hours after radiofrequency ablation for twin reversed arterial perfusion sequence. Frontiers in Medicine. 2022 Apr 14;9:802666. doi: 10.3389/fmed.2022.802666