Abstract
UVVF in both twins. However due to a disproportionate effect on the donor, intertwin difference in UVVF increased from 28 ml/min in stages 1/2 to 58 ml/min in stages 3/4 (p < 0.001). UVVF difference correlated with UA and DV pulsatility (r2, p < 0.001). In 35 patients FLOC resulted in a significant UVVF increase in the donor at 24 & 48 hours (p < 0.001). This correlated with the appearance of postprocedure bladder filling in the donor. Changes in volume flow were not related to the number of anastomoses or Doppler parameters. Conclusion: Recipients in TTTS have significantly higher UVVF. In early stages the magnitude is greater but intertwin differences are smaller. Placental territory as indicated by umbilical artery Doppler is the main contributor to this effect. As TTTS severity advances donor twins experiences significant decrease in venous flow while the magnitude of UVVF necessary to trigger cardiovascular decompensation in the recipient becomes smaller. FLOC produces a rapid correction of UVVF in the donor that can be clinically assessed by demonstrating bladder filling. The more gradual impacts on the recipient are not apparent in this short study period.
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