FETAL AND NEONATAL ECHOCARDIOGRAPHIC FINDINGS IN TWIN-TWIN TRANSFUSION SYNDROME

OBJECTIVE: The study's aim was to analyze the type of cardiac involvem ent in fetuses or infants with twin-twin transfusion syndrome. STUDY D ESIGN: Seventeen pairs of monochorionic diamniotic twin fetuses with t win-twin transfusion syndrome underwent serial Doppler echocardiograph ic studies. Repeated decompressive amniocenteses were performed in all pregnancies. RESULTS: No specific cardiac involvement was seen in don or twins in utero or after birth. All recipient twin fetuses showed va riable degrees of biventricular hypertrophy and dilation with tricuspi d regurgitation. These features were also evident in 45% of the recipi ent twin neonates. The fluid unbalance resolved with serial amniocente ses in 9 cases and in a further 2 after the death of the donor twin; i n all 11 of these recipient twin fetuses there was some degree of impr ovement of the cardiac involvement, which became normal in all survivi ng recipient twin infants within 40 days to 6 months after birth. CONC LUSION: Features of cardiac hypertrophy with signs of a prehydropic or hydropic state develop during fetal life in recipient twins in twin-t win transfusion syndrome; this impairment is reversible with the resol ution of the fluid imbalance or after delivery.