In vitro simulation of acute feto-fetal transfusion in case of single intrauterine fetal death in monochorionic twins

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F21%3A43921827" target="_blank" >RIV/00216208:11120/21:43921827 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00023698:_____/21:N0000007 RIV/00216208:11140/21:10427934

Výsledek na webu

<a href="https://doi.org/10.1016/j.placenta.2021.05.004" target="_blank" >https://doi.org/10.1016/j.placenta.2021.05.004</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.placenta.2021.05.004" target="_blank" >10.1016/j.placenta.2021.05.004</a>

Jazyk výsledku

angličtina

Název v původním jazyce

In vitro simulation of acute feto-fetal transfusion in case of single intrauterine fetal death in monochorionic twins

Popis výsledku v původním jazyce

INTRODUCTION: Thanks to shared circulation in monochorionic twins, single intrauterine fetal death (IUD) may lead to acute feto-fetal transfusion (aFFTR). The objective of the study was to describe our model of aFFTR simulation after IUD in monochorionic (MC) twins. METHODS: Prospective study analyzed 99 fresh MC placentas with the physiological course. A specially designed protocol was used for the preparation and analysis of the placentas. A pair of infusion sets fixed together using a mechanical mercury sphygmomanometer cuff was connected to the cannulated umbilical arteries. The tonometer was pressurized up to 30 and 40 mmHg. A positive finding of aFFTR was determined as the amount exceeding 1 ml of dye flowed out of the umbilical cord simulating a dead fetus. The number and types of anastomoses, types, and distances between cords insertions, and the size of the placental areas for each fetus were also statistically analyzed. The placental angioarchitecture with and without proven aFFTR was statistically compared, odds ratio (OR) and multivariable logistic analysis were performed. RESULTS: A total of 49/99 (49.5%) cases of aFFTR was proven, and the average transfusion time of 1 ml was 30 s (19-46 s). aFFTR was present in 49/78 (62.8%) of placentas with arterio-arterial (AA) anastomosis. The median diameter of AA anastomoses with the present, and absent aFFTRF was 2.0 mm and 1.0 mm, respectively. The proven interfetal transfusion was 8%, 31%, and 61% in AA anastomoses with a diameter below 0,5 mm, 0,5-1,5 mm, and above 1,5 mm, respectively (p &lt; 0,001). AA anastomoses diameter &gt;1.5 mm had OR of 44.2 (95% CI 5.54-352.39). In the case of coexistence of AA anastomosis and umbilical cord distance LESS-THAN OR EQUAL TO5th percentile, the aFFTRF occurred in 90.9%. DISCUSSION: The potential risk of aFFTR in monochorionic twins is mainly due to the presence and nature of AA anastomoses. The diameter and length of the vessels play a crucial role, which is clinically related to the distance of the umbilical cords insertions.

Název v anglickém jazyce

In vitro simulation of acute feto-fetal transfusion in case of single intrauterine fetal death in monochorionic twins

Popis výsledku anglicky

INTRODUCTION: Thanks to shared circulation in monochorionic twins, single intrauterine fetal death (IUD) may lead to acute feto-fetal transfusion (aFFTR). The objective of the study was to describe our model of aFFTR simulation after IUD in monochorionic (MC) twins. METHODS: Prospective study analyzed 99 fresh MC placentas with the physiological course. A specially designed protocol was used for the preparation and analysis of the placentas. A pair of infusion sets fixed together using a mechanical mercury sphygmomanometer cuff was connected to the cannulated umbilical arteries. The tonometer was pressurized up to 30 and 40 mmHg. A positive finding of aFFTR was determined as the amount exceeding 1 ml of dye flowed out of the umbilical cord simulating a dead fetus. The number and types of anastomoses, types, and distances between cords insertions, and the size of the placental areas for each fetus were also statistically analyzed. The placental angioarchitecture with and without proven aFFTR was statistically compared, odds ratio (OR) and multivariable logistic analysis were performed. RESULTS: A total of 49/99 (49.5%) cases of aFFTR was proven, and the average transfusion time of 1 ml was 30 s (19-46 s). aFFTR was present in 49/78 (62.8%) of placentas with arterio-arterial (AA) anastomosis. The median diameter of AA anastomoses with the present, and absent aFFTRF was 2.0 mm and 1.0 mm, respectively. The proven interfetal transfusion was 8%, 31%, and 61% in AA anastomoses with a diameter below 0,5 mm, 0,5-1,5 mm, and above 1,5 mm, respectively (p &lt; 0,001). AA anastomoses diameter &gt;1.5 mm had OR of 44.2 (95% CI 5.54-352.39). In the case of coexistence of AA anastomosis and umbilical cord distance LESS-THAN OR EQUAL TO5th percentile, the aFFTRF occurred in 90.9%. DISCUSSION: The potential risk of aFFTR in monochorionic twins is mainly due to the presence and nature of AA anastomoses. The diameter and length of the vessels play a crucial role, which is clinically related to the distance of the umbilical cords insertions.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30209 - Paediatrics

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2021

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Placenta

ISSN

0143-4004

e-ISSN

—

Svazek periodika

111

Číslo periodika v rámci svazku

August

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

7

Strana od-do

26-32

Kód UT WoS článku

000690348500004

EID výsledku v databázi Scopus

2-s2.0-85107951489