{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T06:53:53Z","timestamp":1780556033948,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Twin\u2013twin transfusion syndrome (TTTS) is characterized by unequal hemodynamics between the twins. We aimed to assess preoperatively the difference in umbilical vein flow (UVF) between the recipient and donor monochorionic diamniotic twins  and evaluate the change in UVF following laser surgery in both twins.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a retrospective cohort study of differences in UVF that occurred following laser surgical treatment of TTTS. Sonographic assessment of the umbilical vein before and 24\u2009h after fetoscopic laser surgery for TTTS was performed. Umbilical vein diameter and time\u2010averaged maximum velocity were measured, and UVF per kg (UVF\/kg) was converted into a\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score by a calculator created using gestational age as an independent variable.\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score values were converted into centiles, which were evaluated statistically. Median differences in UVF\/kg centile values were adjusted for TTTS stage and presence of arterioarterial anastomoses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study population consisted of 363 TTTS patients. The adjusted preoperative median difference in UVF\/kg centile between the recipient\n                      <jats:italic>vs<\/jats:italic>\n                      donor twin was 17.9% (\u221217.1% to 57.6%),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001. The adjusted median difference in UVF\/kg centile between the postoperative\n                      <jats:italic>vs<\/jats:italic>\n                      preoperative period among recipients was 2.2% (\u221210.8% to 13.8%),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001, while the adjusted median difference among donors was 27.3% (8.2%\u201334.6%),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The preoperative difference in UVF between the recipient and donor twins confirms the pathophysiology of TTTS. Postoperatively, the substantial increase in UVF of the donor twin and the relatively small increase in UVF of the recipient twin confirm that ablation of the vascular communications resulted in rapid improvement in perfusion of the donor twin. \u00a9 2022 The Authors. Ultrasound in Obstetrics &amp; Gynecology published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.26041","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T06:32:56Z","timestamp":1659335576000},"page":"774-779","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Correction of fetal umbilical vein flow imbalance following laser surgery for twin\u2013twin transfusion syndrome"],"prefix":"10.1002","volume":"60","author":[{"given":"R. H.","family":"Saab","sequence":"first","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology Keck School of Medicine, University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. R.","family":"DeVore","sequence":"additional","affiliation":[{"name":"Fetal Diagnostic Centers  Pasadena CA USA"},{"name":"Department of Obstetrics and Gynecology David Geffen School of Medicine, UCLA  Los Angeles CA USA"},{"name":"Department of Obstetrics and Gynecology Wayne State University  Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Monson","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology Keck School of Medicine, University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Masri","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology Keck School of Medicine, University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. M.","family":"Korst","sequence":"additional","affiliation":[{"name":"Childbirth Research Associates  North Hollywood CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4202-0259","authenticated-orcid":false,"given":"R. H.","family":"Chmait","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology Keck School of Medicine, University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.10.880"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200292"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032597"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000341814"},{"key":"e_1_2_7_6_1","first-page":"CD002073","article-title":"Interventions for the treatment of twin\u2013twin transfusion syndrome","volume":"1","author":"Roberts D","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22054"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/thg.2016.33"},{"issue":"346","key":"e_1_2_7_9_1","first-page":"e1","article-title":"North American Fetal Therapy Network: intervention vs expectant management for stage I twin\u2010twin transfusion syndrome","volume":"215","author":"Emery SP","year":"2016","journal-title":"Am J Obstet Gynecol"},{"issue":"528","key":"e_1_2_7_10_1","first-page":"e1","article-title":"Intrauterine fetoscopic laser surgery versus expectant management in stage 1 twin\u2010to\u2010twin transfusion syndrome: an international randomized trial","volume":"224","author":"Stirnemann J","year":"2021","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2018.1506441"},{"issue":"393","key":"e_1_2_7_12_1","first-page":"e1","article-title":"Stage\u2010based outcomes of 682 consecutive cases of twin\u2010twin transfusion syndrome treated with laser surgery: the US Fetus experience","volume":"204","author":"Chmait RH","year":"2011","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2010.29.10.1431"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2002.00749.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1104"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3959"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6227"},{"issue":"479","key":"e_1_2_7_18_1","first-page":"e1","article-title":"Changes in umbilical venous volume flow after fetoscopic laser occlusion of placental vascular anastomoses in twin\u2010to\u2010twin transfusion syndrome","volume":"203","author":"Baschat AA","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15872"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6094"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5306"},{"key":"e_1_2_7_22_1","first-page":"1","article-title":"Comparison of placental characteristics of twin\u2013twin transfusion syndrome with and without selective intrauterine growth restriction","author":"Wang X","year":"2020","journal-title":"J Matern Fetal Neonatal Med"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2014.960834"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000127881.34144.d8"},{"issue":"47","key":"e_1_2_7_25_1","first-page":"305","article-title":"Reliability and characteristics of ultrasound measurement of fetal umbilical venous blood flow volume according to the site of measurement","volume":"2020","author":"Kanazawa S","year":"2001","journal-title":"J Med Ultrason"}],"container-title":["Ultrasound in Obstetrics &amp; 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