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Maternal cardiac function in twin pregnancy.

Nikos A Kametas1, Fionnuala McAuliffe, Elisabeth Krampl

  • 1Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, United Kingdom. n.kametas@btinternet.com

Obstetrics and Gynecology
|October 11, 2003
PubMed
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Twin pregnancy causes a more hyperdynamic maternal circulation than singleton pregnancy, with significant changes in cardiac output and left ventricular function. These effects become more pronounced after 20 weeks gestation.

Area of Science:

  • Cardiovascular Physiology
  • Maternal-Fetal Medicine
  • Obstetrics

Background:

  • Twin pregnancies present unique physiological challenges compared to singleton gestations.
  • Understanding maternal cardiac adaptation is crucial for managing twin pregnancies.
  • Previous studies have suggested altered hemodynamics in twin pregnancies, but detailed cardiac function analysis is needed.

Purpose of the Study:

  • To investigate and characterize maternal cardiac function during twin pregnancy.
  • To compare cardiac parameters in women with twin pregnancies versus those with singleton pregnancies.
  • To assess the impact of gestational age on maternal cardiac adaptation in twin gestations.

Main Methods:

  • A cross-sectional study involving 119 women with twin pregnancies (10-40 weeks gestation).

Related Experiment Videos

  • Two-dimensional and M-mode echocardiography of the left ventricle was performed.
  • Cardiac measurements were compared to a historical cohort of 128 women with singleton pregnancies.

    • Main Results:

    • Twin pregnancies exhibited a 20% greater maternal cardiac output, driven by increased stroke volume and heart rate.
    • Left ventricular dimensions, mass, fractional shortening, and ejection fraction were significantly greater in women with twins.
    • Mean arterial pressure and global shortening time showed dynamic changes with gestational age, while long axis shortening decreased at term.

    Conclusions:

    • Twin pregnancy is associated with a more hyperdynamic circulatory state than singleton pregnancy.
    • Left ventricle longitudinal systolic function and mean arterial pressure are significantly altered after 20 weeks in twin pregnancies.
    • The findings highlight the substantial cardiovascular adaptations required for twin gestation.