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Accurate and Simple Evaluation of Vascular Anastomoses in Monochorionic Placenta using Colored Dye
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Uncomplicated Monochorionic Twins: Two Normal Hearts Sharing One Placenta.

Ximena Torres1,2, Mar Bennasar1,2,3, Laura García-Otero1

  • 1Fetal Medicine Research Center, BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), 08028 Barcelona, Spain.

Journal of Clinical Medicine
|November 13, 2020
PubMed
Summary

Uncomplicated monochorionic diamniotic (MCDA) twins show normal fetal heart function but exhibit cardiac adaptations. Echocardiography and B-type natriuretic peptide (BNP) levels reveal these changes compared to singletons.

Keywords:
B-type natriuretic peptidecardiac adaptationcardiac functioncardiac shapefetal echocardiographyuncomplicated monochorionic twins

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Area of Science:

  • Perinatology
  • Fetal Cardiology
  • Maternal-Fetal Medicine

Background:

  • Cardiovascular dysfunction is known in complicated monochorionic diamniotic (MCDA) pregnancies.
  • Hemodynamic changes in uncomplicated MCDA pregnancies are not well understood.

Purpose of the Study:

  • To investigate whether hemodynamic changes occur in uncomplicated MCDA twins.
  • To compare cardiac function and adaptation in uncomplicated MCDA twins versus low-risk singletons.

Main Methods:

  • Prospective observational study of 100 uncomplicated MCDA twins and 200 matched low-risk singletons.
  • Echocardiography performed at 26-30 weeks gestation.
  • Cord blood B-type natriuretic peptide (BNP) measured at delivery.

Main Results:

  • MCDA twins had larger atrial areas and signs of concentric hypertrophy compared to singletons.
  • Longitudinal cardiac function was increased in MCDA twins, indicated by higher annular plane systolic excursion.
  • BNP levels at birth were significantly higher in MCDA twins.

Conclusions:

  • Uncomplicated MCDA fetuses exhibit normal cardiac shape and function.
  • Echocardiographic and biochemical parameters indicate cardiac adaptation in uncomplicated MCDA twins compared to singletons.