{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:42:17Z","timestamp":1757702537272},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2006,7,5]],"date-time":"2006-07-05T00:00:00Z","timestamp":1152057600000},"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":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2006,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To estimate changes in umbilical blood flow (UBF) and Doppler indices in pregnancies complicated by twin\u2010to\u2010twin transfusion syndrome (TTS) treated with either laser therapy or amniodrainage, and to evaluate the influence of the presence of hemodynamic deterioration prior to therapy, as determined by the Quintero stages of severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010eight cases of TTS were included, and further classified into severity Stages I or II (absence of critically abnormal Dopplers (CAD), <jats:italic>n<\/jats:italic> = 22) and Stages III or IV (presence of CAD or hydrops fetalis, <jats:italic>n<\/jats:italic> = 26). In Stages I\u2013II, 14 cases were treated with laser and eight with amniodrainage, and in Stages III\u2013IV, 17 were treated with laser and nine with amniodrainage. Differences in the UBF, umbilical artery pulstility index (UA\u2010PI) and ductus venosus pulsatility index (DV\u2010PI) were estimated for both groups of severity before and after both treatments. Eleven normal monochorionic pregnancies were evaluated as controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In recipients, UBF was significantly higher with respect to controls regardless of the stage, while donors had a significant decrease in UBF, but only in Stages III\u2013IV. After laser treatment no changes were observed in fetuses in Stages I\u2013II. In Stages III\u2013IV, recipients showed a significant reduction in the DV\u2010PI (mean DV\u2010PI 1.31 \u00b1 0.18 vs. 1.05 \u00b1 0.22; <jats:italic>P<\/jats:italic> = 0.005) whereas donors showed a significant increase in the UBF (mean UBF 134 \u00b1 36 mL\/min vs. 195 \u00b1 25 mL\/min; <jats:italic>P<\/jats:italic> &lt; 0.001) and in the DV\u2010PI (mean DV\u2010PI 0.99 \u00b1 0.26 vs. 1.36 \u00b1 0.42; <jats:italic>P<\/jats:italic> = 0.002), and a reduction in the UA\u2010PI (mean UA\u2010PI 1.86 \u00b1 0.41 vs. 1.58 \u00b1 0.30; <jats:italic>P<\/jats:italic> = 0.01). After amniodrainage only donor fetuses in Stages III\u2013IV showed an increase in UA\u2010PI (mean UA\u2010PI 1.54 \u00b1 0.35 vs. 1.72 \u00b1 0.40; <jats:italic>P<\/jats:italic> = 0.015). No other changes were observed in any of the parameters studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Laser therapy induces consistent hemodynamic variations in TTS mainly manifested in Stages III\u2013IV. Copyright \u00a9 2006 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.2734","type":"journal-article","created":{"date-parts":[[2006,7,6]],"date-time":"2006-07-06T04:12:43Z","timestamp":1152159163000},"page":"674-680","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Stage\u2010dependent fetal umbilical blood flow changes induced by laser therapy and amniodrainage in twin\u2010to\u2010twin transfusion syndrome"],"prefix":"10.1002","volume":"28","author":[{"given":"J.","family":"Becker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Hernandez\u2010Andrade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Mu\u00f1oz\u2010Abellana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Acosta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Cabero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Gratac\u00f3s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,7,5]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199712)17:13<1227::AID-PD328>3.0.CO;2-4"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2003.10.004"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)00273-1"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.117188"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe048047"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2002.00749.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1104"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1999.14060380.x"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(00)00440-1"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200292"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(85)90298-4"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9440(10)64767-0"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.118845"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2002.00642.x"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004670050476"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.09.015"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0301-5629(84)90167-4"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.2734","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.2734","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,8]],"date-time":"2023-10-08T11:33:04Z","timestamp":1696764784000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.2734"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,7,5]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2006,10]]}},"alternative-id":["10.1002\/uog.2734"],"URL":"https:\/\/doi.org\/10.1002\/uog.2734","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,7,5]]},"assertion":[{"value":"2005-11-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2006-07-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}