Right ventricular outflow tract abnormalities in monochorionic twin pregnancies without twin-to-twin transfusion syndrome : Prenatal course and postnatal long-term outcomes
Articolo
Data di Pubblicazione:
2021
Citazione:
Right ventricular outflow tract abnormalities in monochorionic twin pregnancies without twin-to-twin transfusion syndrome : Prenatal course and postnatal long-term outcomes / S. Faiola, D. Casati, A. Laoreti, M. Amendolara, D. Consonni, C. Corti, S. Mannarino, M. Lanna, M. Rustico, I. Cetin. - In: PRENATAL DIAGNOSIS. - ISSN 0197-3851. - 41:12(2021 Nov), pp. 1510-1517. [10.1002/pd.6052]
Abstract:
Objectives: Right ventricular outflow tract abnormalities (RVOTA) have been mostly reported in recipient twins (RT) of monochorionic/diamniotic (MC/DA) twin pregnancies with twin-to-twin transfusion syndrome (TTTS).
Aim of the study was to describe RVOTA detected in MC/DA pregnancies without TTTS.
Methods: Cases of RVOTA were retrieved from our database among all MC/DA pregnancies without TTTS from 2009 to 2018.
Results: Out of 891 MC/DA twin pregnancies without TTTS, 14 (1.6%) were associated with RVOTA: 10 pulmonary stenosis (PS), one steno-insufficiency, one insufficiency and two atresia (PA). In 93% of cases (13/14), pregnancy was complicated either by amniotic fluid discrepancy (AFD) or by TAPS or mostly by selective fetal growth restriction (sFGR) (11/13: 85%), involving predominantly (10/11: 91%) the large twin, with high incidence (9/11: 82%) of sFGR and AFD coexistence. Eight out of 14 (57%) survived after the perinatal period (7 PS, 1 PA). Five (62%) underwent pulmonary balloon valvuloplasty, whereas 3 children still showed persistent mild PS at cardiac follow up after 1 year of life.
Conclusions: RVOTA can occur in MC/DA pregnancies without TTTS, particularly when other complications coexist. In complicated cases specialized fetal echocardiographic evaluation is recommended during pregnancy; RVOTA cases should be delivered in a tertiary level center, where cardiologists are available.
Key points
What is already known about this topic?
- Right ventricular outflow tract abnormalities (RVOTA) is the typical cardiac abnormality of
recipient twin in monocorionic/diamniotic (MC/DA) pregnancies complicated by twin‐totwin
transfusion syndrome (TTTS)
- RVOTA has been sporadically reported in (MC/DA) not complicated by TTTS
What does this study add?
- This is the largest reported cohort of RVOTA cases in MC/DA without TTTS.
Tipologia IRIS:
01 - Articolo su periodico
Elenco autori:
S. Faiola, D. Casati, A. Laoreti, M. Amendolara, D. Consonni, C. Corti, S. Mannarino, M. Lanna, M. Rustico, I. Cetin
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