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Neonatal Hemodynamic Characteristics of the Recipient Twin of Twin-To-Twin Transfusion Syndrome Not Treated with Fetoscopic Laser Surgery.
- Source :
- Children; Nov2022, Vol. 9 Issue 11, p1766, 12p
- Publication Year :
- 2022
-
Abstract
- Background: This paper's intent is to describe the neonatal hemodynamic characteristics of recipient twins of monochorionic pregnancies complicated with twin-to-twin transfusion syndrome (TTTS), born without prenatal fetoscopic selective laser coagulation (FSLC). Methods: Retrospective analysis of hemodynamic characteristics was performed during the first five days of life of recipient twins from untreated TTTS. Results: Forty-two recipient twins were included and divided into three groups: no hemodynamic impairment (NoHI) (n = 15, 36%), isolated high blood pressure (HighBP) (n = 12, 28%), and cardiac failure group (CF) (n = 15, 36%). Patients of both CF and HighBP groups had high systolic blood pressure during the first 12 h of life and ventricular hypertrophy at early echocardiography. Cardiac failure occurred at a median age of 14 h (IQR = 6–24) and was followed by a drop in systolic and diastolic blood pressure. Acute kidney injury was more frequent (93% vs. 25%, p < 0.001) and severe (p <0.001) in the CF group than in the HighBP group. The mortality rate in the CF group was 40%. Factors associated with CF were twin anemia-polycythemia sequence (p = 0.012), very preterm birth (p = 0.040), and polycythemia (p = 0.002). Conclusion: One-third of recipient twins born without prenatal FSLC developed life-threatening cardiac failure during the first 24 h of life. [ABSTRACT FROM AUTHOR]
- Subjects :
- NEWBORN screening
HYPERTENSION
ECHOCARDIOGRAPHY
KRUSKAL-Wallis Test
ANTIHYPERTENSIVE agents
NEONATAL intensive care
PREMATURE infants
CONFIDENCE intervals
HEMATOCRIT
SYSTOLIC blood pressure
LEFT ventricular hypertrophy
DOBUTAMINE
FETOFETAL transfusion
TWINS
RETROSPECTIVE studies
TERTIARY care
NEONATAL intensive care units
POLYCYTHEMIA
MANN Whitney U Test
FISHER exact test
RISK assessment
DIASTOLIC blood pressure
HOSPITAL mortality
SEVERITY of illness index
COMPARATIVE studies
PUERPERIUM
PREGNANCY complications
DESCRIPTIVE statistics
MILRINONE
HEMODILUTION
DIURESIS
HEMODYNAMICS
HYPOTENSION
INFANT mortality
APGAR score
LONGITUDINAL method
HEART failure
ACUTE kidney failure
Subjects
Details
- Language :
- English
- ISSN :
- 22279067
- Volume :
- 9
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- Children
- Publication Type :
- Academic Journal
- Accession number :
- 162337483
- Full Text :
- https://doi.org/10.3390/children9111766