Journal of Ultrasound in Medicine, Vol 7, Issue 3 117-124, Copyright © 1988 by American Institute of Ultrasound in Medicine
Doppler ultrasound of twin transfusion syndrome
D. H. Pretorius, D. Manchester, S. Barkin, S. Parker and T. R. Nelson
Department of Radiology, University of California, San Diego 92103.
Doppler sonography of umbilical arteries was used to evaluate eight cases
of twin transfusion syndrome (TTS). Data were collected regarding the
Doppler and real-time sonographic evaluation, clinical course, and outcome.
In addition, the literature was reviewed. An abnormal peak systolic
velocity (A) to end diastolic velocity (B) ratio, as defined by Giles et
al, was seen in at least one twin in five cases. A difference in the A/B
ratios between the two twins was greater than 0.4 in all eight cases.
Doppler studies were able to suggest which fetus was encountering greater
placental resistance, however they could not differentiate donor from
recipient or provide prognostic data regarding outcome. Doppler evaluation
was helpful when there was uncertainty as to whether growth discrepancy in
a twin pregnancy was significant enough to suggest a pathologic state. In
the future, Doppler sonography may be helpful in evaluating the
effectiveness of therapy in TTS. Variable Doppler findings confirm that TTS
is an extremely complex dynamic physiologic state.
