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Association of amniotic fluid natriuretic peptide levels with ductus venosus Doppler flow in recipient twins with twin-to-twin transfusion syndrome

DV flow and NT-proBNP in TTTS recipient twins

  • Original Article–Obstetrics & Gynecology
  • Published:
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Abstract

Purpose

This study examined the relationships between fetal quantitative Doppler parameters and amniotic fluid N-terminal prohormone brain natriuretic peptide (afNT-proBNP) levels as a biomarker of the increased cardiac load in recipient twins with twin-to-twin transfusion syndrome (TTTS).

Methods

This single-center, prospective study included all monochorionic diamniotic (MD) twin pregnancies that were diagnosed with TTTS and underwent fetoscopic laser surgery. Doppler flow was used to measure the pulsatility index (PI) of the umbilical artery (UA), ductus venosus (DV), and middle cerebral artery (MCA) of each recipient and donor twins. The afNT-proBNP levels of recipient twins were examined at the time of surgery. The Spearman or Pearson correlation coefficients were used to assess the relationships between afNT-proBNP levels and Doppler parameters.

Results

A total of 150 MD twin pregnancies were included. The afNT-proBNP levels of the recipient twins showed a stronger correlation with the DV-PI (r = 0.637; P < 0.001) of recipient twins than with the UA-PI and MCA-PI of recipient twins. The Doppler parameters of donor twins were scarcely correlated with the afNT-proBNP levels of the recipient twins.

Conclusion

A positive correlation between the DV-PI and afNT-proBNP levels of recipient twins with TTTS was observed. The recipient twin with an increased DV-PI is expected to be under a high cardiac load; therefore, DV-PI is a useful parameter for assessing increased NT-proBNP levels consecutively and noninvasively.

Clinical Trial Registration

This study was registered with Japanese Clinical Trial Registry “UMIN-CTR” (http://www.umin.ac.jp/ctr/index-j.htm; trial ID numbers UMIN000024486 and 000037702).

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Acknowledgements

This work was partially supported by JSPS KAKENHI (grant number JP19K09788).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Medicine, Toho University, 5-21-16 Omorinishi, Ota-ku, Tokyo, 143-8540, Japan

    Mayumi Takano, Sumito Nagasaki, Junya Sakuma & Masahiko Nakata

  2. Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Tokyo, Japan

    Sumito Nagasaki, Junya Sakuma, Makiko Shimabukuro, Hikari Kotaki & Masahiko Nakata

  3. Department of Obstetrics and Gynecology, Toho University Graduate School of Medicine, Tokyo, Japan

    Makiko Shimabukuro, Hikari Kotaki & Masahiko Nakata

Authors
  1. Mayumi Takano
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  2. Sumito Nagasaki
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  3. Junya Sakuma
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  4. Makiko Shimabukuro
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  5. Hikari Kotaki
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  6. Masahiko Nakata
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Corresponding author

Correspondence to Mayumi Takano.

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The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

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Takano, M., Nagasaki, S., Sakuma, J. et al. Association of amniotic fluid natriuretic peptide levels with ductus venosus Doppler flow in recipient twins with twin-to-twin transfusion syndrome. J Med Ultrasonics 49, 703–708 (2022). https://doi.org/10.1007/s10396-022-01241-3

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  • DOI: https://doi.org/10.1007/s10396-022-01241-3

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