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Can twin fetuses be numerically clustered characterizing fetal cardiovascular system function?

S Yanai1, S Satoh, T Koyanagi

  • 1Department of Gynecology and Obstetrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

Early Human Development
|April 25, 1997
PubMed
Summary

This study identified three distinct groups of twin fetuses based on cardiovascular function. Cluster 1 exhibited significant cardiovascular and renal issues, leading to higher mortality, while Clusters 2 and 3 showed less severe complications.

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Area of Science:

  • Perinatology
  • Fetal Cardiology
  • Quantitative Ultrasound

Background:

  • Assessing in utero cardiovascular function in twins is crucial for understanding fetal well-being.
  • Quantitative analysis can potentially differentiate fetal groups based on physiological parameters.

Purpose of the Study:

  • To quantitatively cluster twin fetuses based on in utero cardiovascular system function.
  • To identify distinct physiological profiles and associated perinatal outcomes in twin pregnancies.

Main Methods:

  • Cluster analysis was performed on 71 twin-paired fetuses (24-40 weeks gestation).
  • Four variables were used: right ventricle end-diastolic dimension (EDD), fractional shortening (FS), umbilical artery resistance index (RIUA), and urine production rate (UPR).
  • Fetal groups were compared to singleton pregnancies and analyzed for perinatal mortality and discordancy.

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Main Results:

  • Three clusters were identified: C1 (significant cardiac/renal dysfunction, higher mortality), C2 (smaller fetuses with placental insufficiency/IUGR), and C3 (normal circulation).
  • C1 showed higher rates of discordancy, hemoglobin difference, and monochorionic placentation.
  • C2 exhibited higher discordancy and small-for-gestational age fetuses compared to C3.

Conclusions:

  • Cluster analysis effectively categorizes twin fetuses based on cardiovascular and renal function.
  • C1 represents twins with severe cardiac and renal compromise, leading to increased perinatal mortality.
  • C2 indicates placental insufficiency and intrauterine growth retardation in smaller fetuses, while C3 represents normal fetal development.