Journal of Ultrasound in Medicine, Vol 14, Issue 2 101-108, Copyright © 1995 by American Institute of Ultrasound in Medicine
Fetal arterial Doppler studies in twin-twin transfusion syndrome
K. Hecher, Y. Ville and K. H. Nicolaides
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, London, England.
This cross-sectional study investigates the circulatory profile of the
donor and recipient fetuses in pregnancies with twin-twin transfusion
syndrome manifested by acute polyhydramnios during the second trimester of
pregnancy. Doppler investigations of the umbilical arteries and of the
fetal descending thoracic aortas and middle cerebral arteries were
performed in both fetuses of 27 pregnancies with twin-twin transfusion
syndrome at 18 to 25 (mean, 21.7) weeks' gestation. Significant differences
from normal values were increased umbilical artery pulsatility index and
decreased aortic mean velocity in both donor and recipient fetuses,
decreased middle cerebral artery pulsatility index in recipients and
decreased middle cerebral artery mean velocity in donors. Increased
umbilical artery pulsatility index in some donor and recipient fetuses may
be the consequence of abnormal placental development and
polyhydramnios-related compression, respectively. Doppler findings in the
fetal circulation are compatible with hypovolemia in the donor and
hypervolemia with congestive heart failure in the recipient.
