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Longitudinal Doppler references for monochorionic twins and comparison with singletons

OBJECTIVES: To construct monochorionic (MC) twin-specific longitudinal Doppler references for umbilical artery pulsatility index (UA-PI), middle cerebral artery (MCA) PI and peak systolic velocity (PSV) and ductus venosus (DV) PI derived from a strictly selected cohort of uncomplicated MC twins. The...

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Autores principales: Casati, Daniela, Pellegrino, Marcella, Cortinovis, Ivan, Spada, Elena, Lanna, Mariano, Faiola, Stefano, Cetin, Irene, Rustico, Maria Angela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6897428/
https://www.ncbi.nlm.nih.gov/pubmed/31809530
http://dx.doi.org/10.1371/journal.pone.0226090
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author Casati, Daniela
Pellegrino, Marcella
Cortinovis, Ivan
Spada, Elena
Lanna, Mariano
Faiola, Stefano
Cetin, Irene
Rustico, Maria Angela
author_facet Casati, Daniela
Pellegrino, Marcella
Cortinovis, Ivan
Spada, Elena
Lanna, Mariano
Faiola, Stefano
Cetin, Irene
Rustico, Maria Angela
author_sort Casati, Daniela
collection PubMed
description OBJECTIVES: To construct monochorionic (MC) twin-specific longitudinal Doppler references for umbilical artery pulsatility index (UA-PI), middle cerebral artery (MCA) PI and peak systolic velocity (PSV) and ductus venosus (DV) PI derived from a strictly selected cohort of uncomplicated MC twins. The secondary aim of the study was to compare our findings with singleton reference charts. METHODS: A retrospective evaluation was made of all consecutive uncomplicated MC twin pregnancies referred to our Unit from 2010 to 2018. Fortnightly serial examinations were performed of UA-PI, MCA-PI, MCA-PSV and DV-PI, according with the clinical protocol, from 20 to 37 weeks of gestation. We included cases with at least four ultrasound examinations, delivery at our hospital and complete neonatal follow up. A two-step method was used to trace the estimated centile curves: estimation of the median was performed with appropriate fractional polynomials by a multilevel model and estimation of the external centiles through the residuals (quantile regression). The comparison with singletons was made by plotting the references derived from the present study on the referred charts commonly used for singletons. RESULTS: The study group comprised 150 uncomplicated MC twin pairs. Estimated centiles (3(rd), 5(th), 10(th), 50(th), 90(th), 95(th), 97(th)) of UA-PI, MCA-PI, MCA-PSV and DV-PI in function of the gestational age are presented. The comparison with singletons showed substantial differences, with higher UA-PI and lower MCA-PI and PSV median values in MC twins. Median DV PI values were similar to the values for singletons, while the upper centiles were higher in MC twins. CONCLUSIONS: This study sets out MC twin-specific longitudinal references for UA-PI, MCA-PI, MCA-PSV and DV-PI derived from the largest series of uncomplicated MC twin pregnancies presently available. The comparison with singleton reference values underscores the deviation from physiology that is intrinsic to these unique pregnancies and supports the need for MC twin-specific charts.
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spelling pubmed-68974282019-12-13 Longitudinal Doppler references for monochorionic twins and comparison with singletons Casati, Daniela Pellegrino, Marcella Cortinovis, Ivan Spada, Elena Lanna, Mariano Faiola, Stefano Cetin, Irene Rustico, Maria Angela PLoS One Research Article OBJECTIVES: To construct monochorionic (MC) twin-specific longitudinal Doppler references for umbilical artery pulsatility index (UA-PI), middle cerebral artery (MCA) PI and peak systolic velocity (PSV) and ductus venosus (DV) PI derived from a strictly selected cohort of uncomplicated MC twins. The secondary aim of the study was to compare our findings with singleton reference charts. METHODS: A retrospective evaluation was made of all consecutive uncomplicated MC twin pregnancies referred to our Unit from 2010 to 2018. Fortnightly serial examinations were performed of UA-PI, MCA-PI, MCA-PSV and DV-PI, according with the clinical protocol, from 20 to 37 weeks of gestation. We included cases with at least four ultrasound examinations, delivery at our hospital and complete neonatal follow up. A two-step method was used to trace the estimated centile curves: estimation of the median was performed with appropriate fractional polynomials by a multilevel model and estimation of the external centiles through the residuals (quantile regression). The comparison with singletons was made by plotting the references derived from the present study on the referred charts commonly used for singletons. RESULTS: The study group comprised 150 uncomplicated MC twin pairs. Estimated centiles (3(rd), 5(th), 10(th), 50(th), 90(th), 95(th), 97(th)) of UA-PI, MCA-PI, MCA-PSV and DV-PI in function of the gestational age are presented. The comparison with singletons showed substantial differences, with higher UA-PI and lower MCA-PI and PSV median values in MC twins. Median DV PI values were similar to the values for singletons, while the upper centiles were higher in MC twins. CONCLUSIONS: This study sets out MC twin-specific longitudinal references for UA-PI, MCA-PI, MCA-PSV and DV-PI derived from the largest series of uncomplicated MC twin pregnancies presently available. The comparison with singleton reference values underscores the deviation from physiology that is intrinsic to these unique pregnancies and supports the need for MC twin-specific charts. Public Library of Science 2019-12-06 /pmc/articles/PMC6897428/ /pubmed/31809530 http://dx.doi.org/10.1371/journal.pone.0226090 Text en © 2019 Casati et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Casati, Daniela
Pellegrino, Marcella
Cortinovis, Ivan
Spada, Elena
Lanna, Mariano
Faiola, Stefano
Cetin, Irene
Rustico, Maria Angela
Longitudinal Doppler references for monochorionic twins and comparison with singletons
title Longitudinal Doppler references for monochorionic twins and comparison with singletons
title_full Longitudinal Doppler references for monochorionic twins and comparison with singletons
title_fullStr Longitudinal Doppler references for monochorionic twins and comparison with singletons
title_full_unstemmed Longitudinal Doppler references for monochorionic twins and comparison with singletons
title_short Longitudinal Doppler references for monochorionic twins and comparison with singletons
title_sort longitudinal doppler references for monochorionic twins and comparison with singletons
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6897428/
https://www.ncbi.nlm.nih.gov/pubmed/31809530
http://dx.doi.org/10.1371/journal.pone.0226090
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