Cargando…
Maternal Complications and Hemodynamic Changes Following Intrauterine Interventions for Twin-to-Twin Transfusion Syndrome in Monochorionic Diamniotic Twin Pregnancies
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 he...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6572341/ https://www.ncbi.nlm.nih.gov/pubmed/31052564 http://dx.doi.org/10.3390/jcm8050605 |
_version_ | 1783427618054340608 |
---|---|
author | Greimel, Patrick Zenz, Angela Csapó, Bence Haeusler, Martin Lang, Uwe Klaritsch, Philipp |
author_facet | Greimel, Patrick Zenz, Angela Csapó, Bence Haeusler, Martin Lang, Uwe Klaritsch, Philipp |
author_sort | Greimel, Patrick |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6572341 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-65723412019-06-18 Maternal Complications and Hemodynamic Changes Following Intrauterine Interventions for Twin-to-Twin Transfusion Syndrome in Monochorionic Diamniotic Twin Pregnancies Greimel, Patrick Zenz, Angela Csapó, Bence Haeusler, Martin Lang, Uwe Klaritsch, Philipp J Clin Med Article 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. MDPI 2019-05-02 /pmc/articles/PMC6572341/ /pubmed/31052564 http://dx.doi.org/10.3390/jcm8050605 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Greimel, Patrick Zenz, Angela Csapó, Bence Haeusler, Martin Lang, Uwe Klaritsch, Philipp Maternal Complications and Hemodynamic Changes Following Intrauterine Interventions for Twin-to-Twin Transfusion Syndrome in Monochorionic Diamniotic Twin Pregnancies |
title | Maternal Complications and Hemodynamic Changes Following Intrauterine Interventions for Twin-to-Twin Transfusion Syndrome in Monochorionic Diamniotic Twin Pregnancies |
title_full | Maternal Complications and Hemodynamic Changes Following Intrauterine Interventions for Twin-to-Twin Transfusion Syndrome in Monochorionic Diamniotic Twin Pregnancies |
title_fullStr | Maternal Complications and Hemodynamic Changes Following Intrauterine Interventions for Twin-to-Twin Transfusion Syndrome in Monochorionic Diamniotic Twin Pregnancies |
title_full_unstemmed | Maternal Complications and Hemodynamic Changes Following Intrauterine Interventions for Twin-to-Twin Transfusion Syndrome in Monochorionic Diamniotic Twin Pregnancies |
title_short | Maternal Complications and Hemodynamic Changes Following Intrauterine Interventions for Twin-to-Twin Transfusion Syndrome in Monochorionic Diamniotic Twin Pregnancies |
title_sort | maternal complications and hemodynamic changes following intrauterine interventions for twin-to-twin transfusion syndrome in monochorionic diamniotic twin pregnancies |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6572341/ https://www.ncbi.nlm.nih.gov/pubmed/31052564 http://dx.doi.org/10.3390/jcm8050605 |
work_keys_str_mv | AT greimelpatrick maternalcomplicationsandhemodynamicchangesfollowingintrauterineinterventionsfortwintotwintransfusionsyndromeinmonochorionicdiamniotictwinpregnancies AT zenzangela maternalcomplicationsandhemodynamicchangesfollowingintrauterineinterventionsfortwintotwintransfusionsyndromeinmonochorionicdiamniotictwinpregnancies AT csapobence maternalcomplicationsandhemodynamicchangesfollowingintrauterineinterventionsfortwintotwintransfusionsyndromeinmonochorionicdiamniotictwinpregnancies AT haeuslermartin maternalcomplicationsandhemodynamicchangesfollowingintrauterineinterventionsfortwintotwintransfusionsyndromeinmonochorionicdiamniotictwinpregnancies AT languwe maternalcomplicationsandhemodynamicchangesfollowingintrauterineinterventionsfortwintotwintransfusionsyndromeinmonochorionicdiamniotictwinpregnancies AT klaritschphilipp maternalcomplicationsandhemodynamicchangesfollowingintrauterineinterventionsfortwintotwintransfusionsyndromeinmonochorionicdiamniotictwinpregnancies |