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...

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Autores principales: 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
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
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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.
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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
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