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Cardiac adaptation and malformation in twin-twin transfusion syndrome and selective fetal growth restriction: A systematic review.
- Source :
-
Prenatal diagnosis [Prenat Diagn] 2024 Jun; Vol. 44 (6-7), pp. 832-845. Date of Electronic Publication: 2024 Apr 21. - Publication Year :
- 2024
-
Abstract
- Objectives: This systematic review explores cardiac adaptation in monochorionic (MC) twins with twin-twin transfusion syndrome (TTTS) or selective fetal growth restriction (sFGR) and assesses the risk of congenital heart defects (CHDs).<br />Methods: Adhering to PRISMA guidelines, 63 studies were reviewed (49 on cardiac adaptation, 13 on CHD, one on both). A narrative synthesis of cardiac adaptation patterns was performed. Additionally, a meta-analysis compared the livebirth prevalence of CHD in TTTS and sFGR against uncomplicated MC twins.<br />Results: In TTTS recipients, cardiac function may be impaired for diastolic, systolic, as well as global functions, while in donors, cardiac function is generally preserved. In sFGR, large twins may show hypertrophic cardiomyopathy, and small twins may show impaired systolic function. Co-occurrence of TTTS and sFGR magnifies cardiac impact but is often underreported. Meta-analysis for CHD prevalence revealed a relative risk ratio of 3.5 (95% CI: 2.5-4.9) for TTTS and 2.2 (95%CI: 1.3-3.5) for sFGR compared with uncomplicated MC twins.<br />Conclusions: This study highlights the well-documented cardiac adaptation in TTTS, contrasting with limited understanding in sFGR. Elevated CHD risks were observed in both conditions. Enhanced cardiovascular surveillance is warranted in complicated MC twin pregnancies. Future research should explore cardiac adaptation in sFGR and its long-term consequences.<br /> (© 2024 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd.)
- Subjects :
- Humans
Pregnancy
Female
Heart Defects, Congenital epidemiology
Heart Defects, Congenital physiopathology
Twins, Monozygotic
Heart physiopathology
Fetal Heart physiopathology
Fetal Heart diagnostic imaging
Fetofetal Transfusion epidemiology
Fetofetal Transfusion physiopathology
Fetofetal Transfusion complications
Fetal Growth Retardation epidemiology
Fetal Growth Retardation physiopathology
Adaptation, Physiological
Subjects
Details
- Language :
- English
- ISSN :
- 1097-0223
- Volume :
- 44
- Issue :
- 6-7
- Database :
- MEDLINE
- Journal :
- Prenatal diagnosis
- Publication Type :
- Academic Journal
- Accession number :
- 38643403
- Full Text :
- https://doi.org/10.1002/pd.6575