{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T21:10:57Z","timestamp":1788469857241,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000},"content-version":"vor","delay-in-days":2,"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":[[2023,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop a model based on factors available at the time of diagnosis of twin\u2013twin transfusion syndrome (TTTS) for predicting the probability of dual twin survival following fetoscopic laser photocoagulation (FLP) using a machine\u2010learning algorithm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective study of data collected at two university\u2010affiliated tertiary fetal centers between 2012 and 2021. The cohort included monochorionic diamniotic twin pregnancies complicated by TTTS that underwent FLP. Data were stratified based on survival 30\u2009days after delivery, and cases with dual survival were compared to those without dual survival. A random forest machine\u2010learning algorithm was used to construct a prediction model, and the relative importance value was calculated for each parameter that presented a statistically significant difference between the two study groups and was included in the model. The holdout method was applied to check overfitting of the random forest algorithm. A prediction model for dual twin survival 30\u2009days after delivery was presented based on the test set.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 537 women with monochorionic diamniotic twin pregnancy, of whom 346 (64.4%) had dual twin survival at 30\u2009days after delivery and were compared with 191 (35.6%) cases that had one or no survivors. Univariate analysis demonstrated no differences in demographic parameters between the groups. At the time of diagnosis, the dual\u2010survival group had lower rates of estimated fetal weight (EFW) &lt;\u200910\n                      <jats:sup>th<\/jats:sup>\n                      centile for gestational age in the donor twin (56.4%\n                      <jats:italic>vs<\/jats:italic>\n                      69.4%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004), intertwin EFW discordance &gt;\u200925% (40.8%\n                      <jats:italic>vs<\/jats:italic>\n                      56.5%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001) and anterior placenta (40.5%\n                      <jats:italic>vs<\/jats:italic>\n                      50.0%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.034). Comparison of Doppler findings between the two groups demonstrated significant differences in the donor twin, with a lower rate of pulsatility index (PI) &gt;\u200995\n                      <jats:sup>th<\/jats:sup>\n                      centile in the umbilical artery and ductus venosus and a lower rate of PI &lt;\u20095\n                      <jats:sup>th<\/jats:sup>\n                      centile in the fetal middle cerebral artery in the dual\u2010survival group. Relative importance values for each of these six parameters were calculated, allowing the construction of a prediction model with an area under the receiver\u2010operating\u2010characteristics curve of 0.916 (95%\u2009CI, 0.887\u20130.946).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      We developed a predictive model for dual survival in monochorionic twin pregnancies following FLP for TTTS, which incorporates six variables obtained at the time of diagnosis of TTTS, including donor EFW &lt;\u200910\n                      <jats:sup>th<\/jats:sup>\n                      centile, intertwin EFW discordance &gt;\u200925%, anterior placenta and abnormal PI in the umbilical artery, ductus venosus and middle cerebral artery of the donor twin. This clinically applicable tool may improve treatment planning and patient counseling. \u00a9 2022 International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.26089","type":"journal-article","created":{"date-parts":[[2022,10,3]],"date-time":"2022-10-03T14:44:01Z","timestamp":1664808241000},"page":"511-517","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Prediction of dual survival following fetoscopic laser photocoagulation for twin\u2013twin transfusion syndrome"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5859-9528","authenticated-orcid":false,"given":"E.","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\u00a0Center  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. J.","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal\u2013Fetal Medicine University of Maryland School of Medicine  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9830-2212","authenticated-orcid":false,"given":"J.","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\u00a0Center  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-7965","authenticated-orcid":false,"given":"A. 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\u00a0Center  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0265-9859","authenticated-orcid":false,"given":"M.","family":"Sanz Cortes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery Baylor College of Medicine and Texas Children's Fetal\u00a0Center  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Donepudi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery Baylor College of Medicine and Texas Children's Fetal\u00a0Center  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Harman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal\u2013Fetal Medicine University of Maryland School of Medicine  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Mostafaei","sequence":"additional","affiliation":[{"name":"Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Turan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal\u2013Fetal Medicine University of Maryland School of Medicine  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7887-5737","authenticated-orcid":false,"given":"M. A.","family":"Belfort","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Fetal Therapy and Surgery Baylor College of Medicine and Texas Children's Fetal\u00a0Center  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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\u00a0Center  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(00)70233-X"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000313300"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200292"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032597"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17520"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(18)30127-5"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6049"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.05.004"},{"issue":"392","key":"e_1_2_7_10_1","first-page":"e1","article-title":"The twin\u2013twin transfusion syndrome: spectrum of cardiovascular abnormality and development of a cardiovascular score to assess severity of disease","volume":"197","author":"Rychik J","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(85)90298-4"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.181.1.1887021"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15821"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2014.916680"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5955"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7713"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000437053"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5705"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000374109"},{"issue":"290","key":"e_1_2_7_20_1","first-page":"e1","article-title":"Optimizing the definition of intrauterine growth restriction: the multicenter prospective PORTO Study","volume":"208","author":"Unterscheider J","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4046"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21975"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2020.1745177"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2021-0060"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.26089","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.26089","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:48:30Z","timestamp":1706662110000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.26089"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1002\/uog.26089"],"URL":"https:\/\/doi.org\/10.1002\/uog.26089","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4]]},"assertion":[{"value":"2022-05-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}