P29.02: Maternal hemodynamic in monochorionic twin pregnancy: hypodynamic circulation and reduced cardiac power

Abstract

To assess hemodynamic changes in monochorionic and dichorionic twin pregnancy through 2nd and 3rd trimester. To understand the influence of chorionicity on cardiac function. P29.02: Table 1. 30 dichorionic (DC) and 19 monochorionic (MC) twin pregnancies at 2nd trimester were enrolled. Hemodynamic evaluation was assessed through a non-invasive method (USCOM®) and was repeated in the 3rd trimester. As shown in table 1, in MC cardiac output (CO) decreases in 3rd trimester, while it remains high in DC. Total vascular resistance (TVR) in MC increases in 3rd trimester, while it remains low during 2nd and 3rd trimester in DC. Minute distance (MD), which results similar in MC and DC in 2nd trimester, in 3rd trimester is lower in MC than in DC. Inotropy Index (INO) seems similar in the two groups during 2nd trimester, but it results lower in MC than in DC during 3rd trimester. Finally, the potential to kinetic energy ratio (PKR) results particularly increased in MC during 3rd trimester. Twin pregnancy presents peculiar hemodynamics: DC presents profound hemodynamic changes with low TVR and high CO during the 2nd and 3rd trimester. MC hemodynamics simulates singleton pregnancy but presents hypodynamic circulation and a lower INO: these changes are probably related to a higher arterial impedance of a singular placental bed.