{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T08:53:55Z","timestamp":1784364835055,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T00:00:00Z","timestamp":1672099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess outcomes in twin\u2010twin transfusion syndrome (TTTS) according to middle cerebral artery pulsatility index (MCA\u2010PI) prior to fetoscopic laser photocoagulation (FLPC) surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort analysis of monochorionic\u2010twin pregnancies complicated by TTTS who underwent FLPC at two fetal centers (2012\u20132021). The cohort was stratified according to abnormal MCA\u2010PI of the donor twin, defined as below fifth centile for gestational age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Abnormal MCA\u2010PI of the donor twin was detected in 46 (17.7%) cases compared to 213 (83.3%) controls with no such abnormality. The abnormal PI group presented with higher rates of sFGR (56.5% vs. 36.8% in controls, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.014) and lower donor survival rates within 48\u00a0h after FLPC (73.9 vs. 86.8%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.029). Donor twin survival rates at the time of delivery and 30\u00a0days after birth were lower in the abnormal MCA\u2010PI. Multivariate logistic regression analysis controlling for sFGR and MCA\u2010PI &lt;fifth centile demonstrated the latter to be independently associated with lower survival rates at the time of delivery and 30\u00a0days after birth [OR\u00a0=\u00a00.497 95%CI (0.250\u20130.986) <jats:italic>p<\/jats:italic>\u00a0=\u00a00.045, and OR\u00a0=\u00a00.499 95%CI (0.252\u20130.986), <jats:italic>p<\/jats:italic>\u00a0=\u00a00.046, respectively]. Recipient's survival rates did not differ between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Donor survival at the time of delivery and 30\u00a0days after birth was lower in TTTS cases with MCA\u2010PI&lt;fifth centile for gestational age prior to laser surgery. This parameter may be considered when evaluating prognosis for TTTS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6288","type":"journal-article","created":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T05:05:19Z","timestamp":1671599119000},"page":"102-108","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of middle cerebral artery pulsatility index on donor survival in twin\u2010twin transfusion syndrome"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5859-9528","authenticated-orcid":false,"given":"Eyal","family":"Krispin","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Division of Fetal Therapy and Surgery Baylor College of Medicine and Texas Children's Fetal Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza A.","family":"Shamshirsaz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Division of Fetal Therapy and Surgery Baylor College of Medicine and Texas Children's Fetal Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiba J.","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences Division of Maternal\u2010Fetal Medicine University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael C.","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Division of Fetal Therapy and Surgery Baylor College of Medicine and Texas Children's Fetal Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Espinoza","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Division of Fetal Therapy and Surgery Baylor College of Medicine and Texas Children's Fetal Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6333-3177","authenticated-orcid":false,"given":"Ahmed A.","family":"Nassr","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Division of Fetal Therapy and Surgery Baylor College of Medicine and Texas Children's Fetal Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0265-9859","authenticated-orcid":false,"given":"Magdalena","family":"Sanz\u2010Cortes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Division of Fetal Therapy and Surgery Baylor College of Medicine and Texas Children's Fetal Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chilaka H.","family":"Ugoji","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Division of Fetal Therapy and Surgery Baylor College of Medicine and Texas Children's Fetal Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Harman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences Division of Maternal\u2010Fetal Medicine University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozhan","family":"Turan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences Division of Maternal\u2010Fetal Medicine University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael 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