FETAL ARTERIAL DOPPLER STUDIES IN TWIN-TWIN TRANSFUSION SYNDROME

This cross-sectional study investigates the circulatory profile of the donor and recipient fetuses in pregnancies with twin-twin transfusion syndrome manifested by acute polyhydramnios during the second trimest er pregnancy. Doppler investigations of the umbilical arteries and of the fetal descending thoracic aortas and middle cerebral arteries were performed in both fetuses of 27 pregnancies with twin-twin transfusio n syndrome at 18 to 25 (mean, 21.7) weeks' gestation. Significant diff erences from normal values were increased umbilical artery pulsatility index and decreased aortic mean velocity in both donor and recipient fetuses, decreased middle cerebral artery pulsatility index in recipie nts and decreased middle cerebral artery mean velocity in donors. Incr eased umbilical artery pulsatility index in some donor and recipient f etuses may be the consequence of abnormal placental development and po lyhydramnios-related compression, respectively. Doppler findings in th e fetal circulation are compatible with hypovolemia in the donor and h ypervolemia with congestive heart failure in the recipient.