{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T18:18:15Z","timestamp":1763662695391},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2008,2,6]],"date-time":"2008-02-06T00:00:00Z","timestamp":1202256000000},"content-version":"vor","delay-in-days":5,"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":[[2008,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the influence of fetoscopic laser therapy on fetal cardiac size in monochorionic twins complicated by twin\u2013twin transfusion syndrome (TTTS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a longitudinal, prospective study, we assessed fetal cardiac size sonographically in monochorionic diamniotic twins with TTTS treated by laser therapy and in monochorionic twins without TTTS. The fetal cardiothoracic ratio (cardiac circumference divided by thoracic circumference) of TTTS twins was determined within 24 h before, 12\u201324 h after and 1 week after laser treatment, and from then on every 2\u20134 weeks until birth. TTTS twins were classified into Quintero Stages 1\u20132 (<jats:italic>n<\/jats:italic> = 18) and Stages 3\u20134 (<jats:italic>n<\/jats:italic> = 16), and measurements were compared with biweekly measurements of non\u2010TTTS monochorionic twins matched for gestational age (<jats:italic>n<\/jats:italic> = 38). Cardiomegaly was defined as a cardiothoracic ratio above the 97.5<jats:sup><jats:italic>th<\/jats:italic><\/jats:sup> percentile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Before laser treatment, cardiomegaly was observed in 44% (8\/18) and 50% (8\/16) of recipients in Quintero Stages 1\u20132 and Stages 3\u20134, respectively. Cardiomegaly occurred in none of the donors before treatment. After laser treatment, cardiomegaly was observed in 76% (13\/17) and 50% (7\/14) of recipients in Stages 1\u20132 and Stages 3\u20134, respectively, and in 17% (3\/18) and 13% (2\/15) of donors in Stages 1\u20132 and Stages 3\u20134, respectively. Cardiomegaly was present in 18% (7\/38) and 8% (2\/25) of non\u2010TTTS monochorionic twins and singletons. After laser therapy, the cardiothoracic ratio of recipients in Stages 1\u20132 and Stages 3\u20134 was not significantly changed (<jats:italic>P<\/jats:italic> = 0.34 and <jats:italic>P<\/jats:italic> = 0.67, respectively). The cardiothoracic ratio of donors in Stages 1\u20132 and Stages 3\u20134 was increased compared with that before laser therapy (<jats:italic>P<\/jats:italic> = 0.0002 and <jats:italic>P<\/jats:italic> = 0.005, respectively). Cardiothoracic ratios of non\u2010TTTS monochorionic twins were not significantly different from our reference range in singletons throughout gestation, and were smaller than those in both recipients and donors after laser therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TTTS recipients show cardiomegaly before as well as after fetoscopic laser therapy for TTTS. Donors develop cardiomegaly only after laser treatment. Our findings emphasize the significant effect of TTTS and fetoscopic laser therapy on the fetal heart of both recipient and donor twins. Copyright \u00a9 2008 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.5246","type":"journal-article","created":{"date-parts":[[2008,2,6]],"date-time":"2008-02-06T12:16:56Z","timestamp":1202300216000},"page":"158-163","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The effect of fetoscopic laser therapy on fetal cardiac size in twin\u2013twin transfusion syndrome"],"prefix":"10.1002","volume":"31","author":[{"given":"M.","family":"Sueters","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. M.","family":"Middeldorp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. P. H. A.","family":"Vandenbussche","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. 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