Document Detail


Evaluation of the CHOP cardiovascular score as a prognostic predictor of outcome in twin-twin transfusion syndrome after laser coagulation of placental vessels in a prospective cohort.
MedLine Citation:
PMID:  20582931     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the prognostic value of cardiac function assessment by the previously reported CHOP (Children's Hospital of Philadelphia) cardiovascular score in twin-twin transfusion syndrome (TTTS).
METHODS: All consecutive monochorionic pregnancies presenting with TTTS over a 24-month period were evaluated by preoperative echocardiography before percutaneous laser coagulation of chorionic vessels. Each of the 12 items of the CHOP score was evaluated prospectively and the cardiovascular score was categorized into stages using previously published cut-offs. The outcome considered for this study was neonatal survival of neither, one or both twins.
RESULTS: In total, 215 pregnancies were enrolled. Due to technical issues, CHOP evaluation was incomplete in 16% of cases and follow-up was unavailable in 12%. Overall, there was a significant relationship between the CHOP score and the Quintero staging system, although this relationship was significantly reduced when parameters used in the Quintero system were removed from the CHOP score. Based upon neonatal survival, the CHOP score did not show any prognostic value regarding overall pregnancy outcome or individual recipient survival.
CONCLUSION: Cardiac function assessment using the CHOP score is not of clinical use as a prognostic marker in TTTS. This suggests that cardiac function may not be of interest for preoperative staging when laser coagulation is the first-line treatment, other than to confirm the diagnosis of TTTS requiring surgery.
Authors:
J J Stirnemann; B Nasr; F Proulx; M Essaoui; Y Ville
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  36     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-01     Completed Date:  2010-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  52-7     Citation Subset:  IM    
Copyright Information:
Copyright 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics and Maternal-Fetal Medicine, GHU Necker-Enfants Malades, University Paris Descartes, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Echocardiography / methods
Female
Fetal Heart / physiopathology*,  surgery,  ultrasonography
Fetofetal Transfusion / physiopathology*,  ultrasonography
Gestational Age
Humans
Laser Coagulation / methods
Placenta / blood supply*,  surgery,  ultrasonography
Pregnancy
Pregnancy Outcome
Prognosis
Prospective Studies
Twins
Ultrasonography, Prenatal
Comments/Corrections
Comment In:
Ultrasound Obstet Gynecol. 2010 Nov;36(5):647-8   [PMID:  20981720 ]
Ultrasound Obstet Gynecol. 2010 Jul;36(1):6-9   [PMID:  20582927 ]

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