Document Detail


Risk of persistent pulmonary hypertension of the neonate in twin-to-twin transfusion syndrome.
MedLine Citation:
PMID:  17396038     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Chronic twin-to-twin transfusion syndrome (TTTS) is a complication of monochorionic twin gestations and is associated with high perinatal mortality and increased neurological, cardiovascular and renal morbidity. OBJECTIVE: To report the risk of severe persistent pulmonary hypertension of the newborn (PPHN) in TTTS and discuss the possible association between severe PPHN and TTTS. METHODS: All cases of monochorionic twins with severe PPHN at birth admitted to our nursery between June 2002 and July 2006 were reviewed retrospectively. We compared the incidence of severe PPHN in monochorionic twins with and without TTTS. Severe PPHN was diagnosed according to clinical and ultrasound criteria when an infant with a structurally normal heart had (1) severe hypoxemia and (2) evidence of a right-to-left shunt on persistent ductus arteriosus or foramen ovale, requiring treatment with inhaled nitric oxide (iNO). RESULTS: In a consecutive series of 73 twin pregnancies with TTTS, 4 of the 135 live-born twins (3%) were affected by severe PPHN. All reacted promptly to treatment with iNO. The incidence of severe PPHN in monochorionic twins without TTTS was 0% (0/161). CONCLUSION: In view of the severe clinical course in PPHN and need for adequate and prompt treatment with iNO, perinatologists should be aware of the increased risk of severe PPHN in TTTS.
Authors:
Bas Delsing; Enrico Lopriore; Nico Blom; Arjan B Te Pas; Frank P Vandenbussche; Frans J Walther
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Publication Detail:
Type:  Case Reports; Journal Article; Twin Study     Date:  2007-03-29
Journal Detail:
Title:  Neonatology     Volume:  92     ISSN:  1661-7819     ISO Abbreviation:  -     Publication Date:  2007  
Date Detail:
Created Date:  2007-08-08     Completed Date:  2007-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  134-8     Citation Subset:  IM    
Affiliation:
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Adult
Bronchodilator Agents / therapeutic use*
Comorbidity
Echocardiography
Fatal Outcome
Female
Fetofetal Transfusion / complications,  diagnosis,  epidemiology*,  surgery
Fetoscopy
Gestational Age
Humans
Hypertension, Pulmonary / drug therapy,  epidemiology*,  etiology,  ultrasonography
Infant, Newborn
Male
Netherlands / epidemiology
Nitric Oxide / therapeutic use*
Pregnancy
Risk Factors
Twins, Monozygotic
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 10102-43-9/Nitric Oxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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