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Reference values for differences between cardio-circulatory variables of normal twin fetuses.

S E Sonesson¹, J C Fouron, L Leduc

¹Astrid Lindgren's Children's Hospital, Karolinska Institute, Stockholm, Sweden.

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology

|September 8, 2000

Summary

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Normal reference values for twin fetal cardio-circulatory differences are established. No systematic intertwin differences were found, except for the cardio-thoracic ratio, aiding in diagnosing twin complications.

Area of Science:

Fetal Medicine
Cardiovascular Physiology
Maternal-Fetal Medicine

Background:

Lack of reference values for cardio-circulatory variables in normal twin fetuses.
Need for normal data to identify hemodynamic disparities between twins.

Purpose of the Study:

Establish normal differences in cardio-circulatory parameters between twin fetuses.
Provide reference data for the second and third trimesters of gestation.

Main Methods:

Longitudinal, prospective study of 27 normal twin pregnancies.
Doppler-echocardiographic evaluations every 2-3 weeks from 23 weeks gestation.
Assessed cardio-thoracic ratio, ventricular dimensions, outputs, valve Doppler parameters, and umbilical artery pulsatility index.

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Main Results:

No significant intertwin differences in most cardio-circulatory variables were observed across gestational age.
The cardio-thoracic ratio was the only variable showing a systematic difference between twins.
No consistent difference was found between smaller and larger fetuses, except for the cardio-thoracic ratio.

Conclusions:

Established reference values allow for comparative analysis between twins.
Facilitates the investigation of life-threatening conditions like twin-to-twin transfusion syndrome.
Supports early identification of hemodynamic imbalances in multifetal pregnancies.