{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T18:38:29Z","timestamp":1763663909379,"version":"3.40.5"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,12,4]],"date-time":"2019-12-04T00:00:00Z","timestamp":1575417600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the relationship between intra\u2010amniotic pressure and cervical length (CL) in patients with twin\u2013twin transfusion syndrome (TTTS) undergoing fetoscopic laser photocoagulation (FLP), and to identify pre\u2010 or intraoperative factors associated with increased intra\u2010amniotic pressure in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective cohort study of patients undergoing FLP for TTTS. Exclusion criteria were triplet or higher\u2010order gestation and prior cervical cerclage, amnioreduction or FLP procedure. CL was assessed using preprocedure transvaginal ultrasound. Intra\u2010amniotic pressure measurements were obtained on initial placement of the trocar into the amniotic cavity, using a direct hydrostatic pressure gauge. The relationship between intra\u2010amniotic pressure and CL was assessed using multivariate linear regression analysis, including relevant preoperative and intraoperative variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 283 pregnancies met the inclusion criteria. Quintero stage of TTTS was I in 33 pregnancies, II in 88, III in 150 and IV in 12. Mean gestational age (GA) at FLP was 20.7\u2009\u00b1\u20093\u2009weeks. Mean intra\u2010amniotic pressure was 23.1\u2009\u00b1\u20099\u2009mmHg. On unadjusted linear regression analysis, there was no significant association between intra\u2010amniotic pressure and preoperative CL (<jats:italic>P<\/jats:italic>\u2009=\u20090.24) or GA at delivery (<jats:italic>P<\/jats:italic>\u2009=\u20090.22). On multivariate analysis, the factors associated significantly with intra\u2010amniotic pressure were: number of prior term deliveries (<jats:italic>P<\/jats:italic>\u2009=\u20090.03), recipient maximum vertical pocket (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001), Quintero stage IV (<jats:italic>P<\/jats:italic>\u2009=\u20090.01) and type of anesthesia (sedation <jats:italic>vs<\/jats:italic> general anesthesia; <jats:italic>P<\/jats:italic>\u2009=\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In pregnancies with TTTS, intra\u2010amniotic pressure is not associated with CL or GA at delivery. This novel finding suggests that cervical shortening in this population is not mechanically driven. Copyright \u00a9 2019 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.20228","type":"journal-article","created":{"date-parts":[[2019,1,29]],"date-time":"2019-01-29T06:48:51Z","timestamp":1548744531000},"page":"774-779","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effect of intra\u2010amniotic fluid pressure from polyhydramnios on cervical length in patients with twin\u2013twin transfusion syndrome undergoing fetoscopic laser surgery"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6276-854X","authenticated-orcid":false,"given":"E. P.","family":"Bergh","sequence":"first","affiliation":[{"name":"The Texas Fetal Center, Department of Obstetrics, Gynecology and Reproductive Sciences University of Texas Health Medical School  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. K.","family":"Mann","sequence":"additional","affiliation":[{"name":"The Texas Fetal Center, Department of Obstetrics, Gynecology and Reproductive Sciences University of Texas Health Medical School  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. R.","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology McGovern Medical School  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0387-2755","authenticated-orcid":false,"given":"R.","family":"Donepudi","sequence":"additional","affiliation":[{"name":"The Texas Fetal Center, Department of Obstetrics, Gynecology and Reproductive Sciences University of Texas Health Medical School  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"K. J.","family":"Moise","sequence":"additional","affiliation":[{"name":"The Texas Fetal Center, Department of Obstetrics, Gynecology and Reproductive Sciences University of Texas Health Medical School  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Johnson","sequence":"additional","affiliation":[{"name":"The Texas Fetal Center, Department of Obstetrics, Gynecology and Reproductive Sciences University of Texas Health Medical School  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3801-346X","authenticated-orcid":false,"given":"R.","family":"Papanna","sequence":"additional","affiliation":[{"name":"The Texas Fetal Center, Department of Obstetrics, Gynecology and Reproductive Sciences University of Texas Health Medical School  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,4]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_6_2_1","DOI":"10.1016\/j.ajog.2006.06.069"},{"doi-asserted-by":"publisher","key":"e_1_2_6_3_1","DOI":"10.1097\/01.AOG.0000277261.92756.1a"},{"doi-asserted-by":"publisher","key":"e_1_2_6_4_1","DOI":"10.1115\/1.4036259"},{"doi-asserted-by":"publisher","key":"e_1_2_6_5_1","DOI":"10.1159\/000263555"},{"doi-asserted-by":"publisher","key":"e_1_2_6_6_1","DOI":"10.1016\/0028-2243(93)90199-M"},{"key":"e_1_2_6_7_1","first-page":"210","article-title":"Amniotic pressure in disorders of amniotic fluid volume","volume":"76","author":"Fisk NM","year":"1990","journal-title":"Obstet Gynecol"},{"doi-asserted-by":"publisher","key":"e_1_2_6_8_1","DOI":"10.1159\/000264299"},{"doi-asserted-by":"publisher","key":"e_1_2_6_9_1","DOI":"10.1056\/NEJMoa032597"},{"doi-asserted-by":"publisher","key":"e_1_2_6_10_1","DOI":"10.1159\/000331165"},{"doi-asserted-by":"publisher","key":"e_1_2_6_11_1","DOI":"10.1002\/uog.1798"},{"doi-asserted-by":"publisher","key":"e_1_2_6_12_1","DOI":"10.1002\/uog.14696"},{"doi-asserted-by":"publisher","key":"e_1_2_6_13_1","DOI":"10.1002\/uog.15972"},{"doi-asserted-by":"publisher","key":"e_1_2_6_14_1","DOI":"10.1016\/j.ajog.2007.11.022"},{"doi-asserted-by":"publisher","key":"e_1_2_6_15_1","DOI":"10.1371\/journal.pone.0011037"},{"doi-asserted-by":"publisher","key":"e_1_2_6_16_1","DOI":"10.1371\/journal.pone.0003834"},{"doi-asserted-by":"publisher","key":"e_1_2_6_17_1","DOI":"10.1038\/sj.jp.7200292"},{"doi-asserted-by":"publisher","key":"e_1_2_6_18_1","DOI":"10.3109\/00016925309136722"},{"unstructured":"R Core Team.R: A Language and Environment for Statistical Computing. 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