The Value of Delta Middle Cerebral Artery Peak Systolic Velocity for the Prediction of Twin Anemia-Polycythemia Sequence—Analysis of a Heterogenous Cohort of Monochorionic Twins
Introduction: Twin anemia-polycythemia sequence (TAPS) is a complication in monochorionic-diamniotic (MCDA) twin pregnancies. This study analyzes whether the prenatal diagnosis using delta middle cerebral artery-peak systolic velocity (MCA-PSV) > 0.5 multiples of the median (MoM) (delta group) de...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783345/ https://www.ncbi.nlm.nih.gov/pubmed/36556157 http://dx.doi.org/10.3390/jcm11247541 |
_version_ | 1784857556294828032 |
---|---|
author | de Sainte Fare, Anthea Bedei, Ivonne Wolter, Aline Schenk, Johanna Widriani, Ellydda Keil, Corinna Koehler, Siegmund Bahlmann, Franz Strizek, Brigitte Gembruch, Ulrich Berg, Christoph Axt-Fliedner, Roland |
author_facet | de Sainte Fare, Anthea Bedei, Ivonne Wolter, Aline Schenk, Johanna Widriani, Ellydda Keil, Corinna Koehler, Siegmund Bahlmann, Franz Strizek, Brigitte Gembruch, Ulrich Berg, Christoph Axt-Fliedner, Roland |
author_sort | de Sainte Fare, Anthea |
collection | PubMed |
description | Introduction: Twin anemia-polycythemia sequence (TAPS) is a complication in monochorionic-diamniotic (MCDA) twin pregnancies. This study analyzes whether the prenatal diagnosis using delta middle cerebral artery-peak systolic velocity (MCA-PSV) > 0.5 multiples of the median (MoM) (delta group) detects more TAPS cases than the guideline-based diagnosis using the MCA-PSV cut off levels of >1.5 and <1.0 MoM (cut-off group), in a heterogenous group of MCDA twins. Methods: A retrospective analysis of 348 live-born MCDA twin pregnancies from 2010 to 2021 with available information on MCA-PSV within one week before delivery and hemoglobin-values within 24 h postnatally were considered eligible. Results: Among postnatal confirmed twin pairs with TAPS, the cut-off group showed lower sensitivity than the delta group (33% vs. 82%). Specificity proved higher in the cut-off group with 97% than in the delta group at 86%. The risk that a TAPS is mistakenly not recognized prenatally is higher in the cut-off group than in the delta group (52% vs. 18%). Conclusions: Our data shows that delta MCA-PSV > 0.5 MoM detects more cases of TAPS, which would not have been diagnosed prenatally according to the current guidelines. In the collective examined in the present study, TAPS diagnostics using delta MCA-PSV proved to be a more robust method. |
format | Online Article Text |
id | pubmed-9783345 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-97833452022-12-24 The Value of Delta Middle Cerebral Artery Peak Systolic Velocity for the Prediction of Twin Anemia-Polycythemia Sequence—Analysis of a Heterogenous Cohort of Monochorionic Twins de Sainte Fare, Anthea Bedei, Ivonne Wolter, Aline Schenk, Johanna Widriani, Ellydda Keil, Corinna Koehler, Siegmund Bahlmann, Franz Strizek, Brigitte Gembruch, Ulrich Berg, Christoph Axt-Fliedner, Roland J Clin Med Article Introduction: Twin anemia-polycythemia sequence (TAPS) is a complication in monochorionic-diamniotic (MCDA) twin pregnancies. This study analyzes whether the prenatal diagnosis using delta middle cerebral artery-peak systolic velocity (MCA-PSV) > 0.5 multiples of the median (MoM) (delta group) detects more TAPS cases than the guideline-based diagnosis using the MCA-PSV cut off levels of >1.5 and <1.0 MoM (cut-off group), in a heterogenous group of MCDA twins. Methods: A retrospective analysis of 348 live-born MCDA twin pregnancies from 2010 to 2021 with available information on MCA-PSV within one week before delivery and hemoglobin-values within 24 h postnatally were considered eligible. Results: Among postnatal confirmed twin pairs with TAPS, the cut-off group showed lower sensitivity than the delta group (33% vs. 82%). Specificity proved higher in the cut-off group with 97% than in the delta group at 86%. The risk that a TAPS is mistakenly not recognized prenatally is higher in the cut-off group than in the delta group (52% vs. 18%). Conclusions: Our data shows that delta MCA-PSV > 0.5 MoM detects more cases of TAPS, which would not have been diagnosed prenatally according to the current guidelines. In the collective examined in the present study, TAPS diagnostics using delta MCA-PSV proved to be a more robust method. MDPI 2022-12-19 /pmc/articles/PMC9783345/ /pubmed/36556157 http://dx.doi.org/10.3390/jcm11247541 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article de Sainte Fare, Anthea Bedei, Ivonne Wolter, Aline Schenk, Johanna Widriani, Ellydda Keil, Corinna Koehler, Siegmund Bahlmann, Franz Strizek, Brigitte Gembruch, Ulrich Berg, Christoph Axt-Fliedner, Roland The Value of Delta Middle Cerebral Artery Peak Systolic Velocity for the Prediction of Twin Anemia-Polycythemia Sequence—Analysis of a Heterogenous Cohort of Monochorionic Twins |
title | The Value of Delta Middle Cerebral Artery Peak Systolic Velocity for the Prediction of Twin Anemia-Polycythemia Sequence—Analysis of a Heterogenous Cohort of Monochorionic Twins |
title_full | The Value of Delta Middle Cerebral Artery Peak Systolic Velocity for the Prediction of Twin Anemia-Polycythemia Sequence—Analysis of a Heterogenous Cohort of Monochorionic Twins |
title_fullStr | The Value of Delta Middle Cerebral Artery Peak Systolic Velocity for the Prediction of Twin Anemia-Polycythemia Sequence—Analysis of a Heterogenous Cohort of Monochorionic Twins |
title_full_unstemmed | The Value of Delta Middle Cerebral Artery Peak Systolic Velocity for the Prediction of Twin Anemia-Polycythemia Sequence—Analysis of a Heterogenous Cohort of Monochorionic Twins |
title_short | The Value of Delta Middle Cerebral Artery Peak Systolic Velocity for the Prediction of Twin Anemia-Polycythemia Sequence—Analysis of a Heterogenous Cohort of Monochorionic Twins |
title_sort | value of delta middle cerebral artery peak systolic velocity for the prediction of twin anemia-polycythemia sequence—analysis of a heterogenous cohort of monochorionic twins |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783345/ https://www.ncbi.nlm.nih.gov/pubmed/36556157 http://dx.doi.org/10.3390/jcm11247541 |
work_keys_str_mv | AT desaintefareanthea thevalueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT bedeiivonne thevalueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT wolteraline thevalueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT schenkjohanna thevalueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT widrianiellydda thevalueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT keilcorinna thevalueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT koehlersiegmund thevalueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT bahlmannfranz thevalueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT strizekbrigitte thevalueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT gembruchulrich thevalueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT bergchristoph thevalueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT axtfliednerroland thevalueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT desaintefareanthea valueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT bedeiivonne valueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT wolteraline valueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT schenkjohanna valueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT widrianiellydda valueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT keilcorinna valueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT koehlersiegmund valueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT bahlmannfranz valueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT strizekbrigitte valueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT gembruchulrich valueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT bergchristoph valueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins AT axtfliednerroland valueofdeltamiddlecerebralarterypeaksystolicvelocityforthepredictionoftwinanemiapolycythemiasequenceanalysisofaheterogenouscohortofmonochorionictwins |