Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

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Greimel, P; Zenz, A; Csapó, B; Haeusler, M; Lang, U; Klaritsch, P.
Maternal Complications and Hemodynamic Changes Following Intrauterine Interventions for Twin-to-Twin Transfusion Syndrome in Monochorionic Diamniotic Twin Pregnancies.
J Clin Med. 2019; 8(5): Doi: 10.3390/jcm8050605 [OPEN ACCESS]
Web of Science PubMed FullText FullText_MUG

Führende Autor*innen der Med Uni Graz: Greimel Patrick; Klaritsch Philipp
Co-Autor*innen der Med Uni Graz: Csapo Bence Daniel; Haeusler Martin; Lang Uwe
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Abstract:: Twin-to-twin transfusion syndrome (TTTS) is a challenging complication in monochorionic diamniotic (MCDA) twins. Intrauterine interventions, such as fetoscopic laser ablation and cord occlusion followed by amniodrainage, are established treatments. Little is known about maternal complications and hemodynamics following these interventions. We performed a retrospective analysis of maternal procedure-related complications and the impact of such procedures on maternal hemodynamics and blood characteristics. Within the study period, 100 women with severe TTTS treated by fetoscopic laser ablation (FLA) or cord occlusion (CO) were identified. Clinically relevant maternal complications were reported in four (4%) cases. There was a significant decrease in hemoglobin, hematocrit, and albumin between admission and postoperative measurements (all p < 0.001). Systolic and diastolic blood pressure, as well as maternal heart rate, decreased from time of skin suture to postoperative measurements (all p < 0.001). Within a 24 h interval, there was a positive correlation between hematocrit (Spearman's rho 0.325; p = 0.003), hemoglobin (Spearman's rho 0.379; p < 0.001), and albumin (Spearman's rho 0.360; p = 0.027), and the amount of amniodrainage during the intervention. Maternal procedure-related complications are relatively rare. Significant hemodynamic alterations and maternal hemodilution are common clinical findings following intrauterine interventions.
Find related publications in this database (Keywords): monochorionic diamniotic twins (MCDA); twin-to-twin transfusion syndrome (TTTS); fetoscopy; amniodrainage; maternal complications; mirror syndrome; hemodilution