Maternal cardiac function in twin pregnancy at 19-23 weeks' gestation

Area of Science:

• Cardiovascular physiology in pregnancy
• Maternal adaptations to multifetal gestation

Background:

• Pregnancy necessitates significant maternal cardiovascular adaptations.
• Twin pregnancies impose a greater physiological load than singleton pregnancies.
• Understanding these adaptations is crucial for monitoring maternal health.

Purpose of the Study:

• To compare maternal cardiovascular indices between twin and singleton pregnancies at 19-23 weeks' gestation.
• To assess the impact of chorionicity (monochorionic vs. dichorionic) on these cardiovascular parameters in twin gestations.

Main Methods:

• Prospective observational study of 155 women with twin pregnancies.
• Maternal cardiovascular assessment at 19-24 weeks' gestation.
• Comparison of cardiovascular indices using multiples of the median (MoM) and delta values derived from singleton pregnancy models.

Main Results:

• Twin pregnancies showed increased isovolumetric relaxation time, left atrial area, and myocardial performance index compared to singletons.
• Reduced mitral valve E/A and increased left ventricular mass were observed in twin gestations.
• Differences in specific parameters like left atrial volume and isovolumetric contraction time were noted between dichorionic and monochorionic twins.

Conclusions:

• Maternal systolic and diastolic function are reduced in twin pregnancies at mid-gestation compared to singletons.
• Cardiovascular adaptation patterns in twin pregnancies are similar between monochorionic and dichorionic types.
• These adaptations resemble those seen later in uncomplicated singleton pregnancies.