{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,7,3]],"date-time":"2022-07-03T23:40:28Z","timestamp":1656891628853},"reference-count":34,"publisher":"Cambridge University Press (CUP)","issue":"3-4","license":[{"start":{"date-parts":[[2014,8,1]],"date-time":"2014-08-01T00:00:00Z","timestamp":1406851200000},"content-version":"unspecified","delay-in-days":5783,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta genet. med. gemellol.: twin res."],"published-print":{"date-parts":[[1998,10]]},"abstract":"<jats:p><jats:bold>Objective.<\/jats:bold>The aim of this study was to show the diagnostic possibilities of ultrasound in twin-to-twin transfusion syndrome (TTTS), to demonstrate its usefulness in cases of hemoglobin difference &lt; 5 g\/dL in neonates as well as in cases complicated by intrauterine death of one or both twins.<\/jats:p><jats:p><jats:bold>Study design.<\/jats:bold>The study included 4 pairs of twins. In two cases 3 fetuses died in utero. In the other two the hemoglobin difference in newborn infants was &lt; 5 g\/dL. The ultrasound examination, evaluating the fetal anatomy and biometry, amniotic fluid volume, placentation, was performed. The special attention was paid to polyhydramnios\/oligohydramnios, discordant fetal growth (fetal weight, abdominal circumference), the presence of fetal hydrops, ascites, pericardial effusion. Doppler blood flow velocimetry has been done in umbilical vessels, middle cerebral artery. The data was compared with normal reference values for singleton pregnancies. The waveforms from both uterine arteries were also evaluated to exclude placental insufficiency. Additionally the blood flow through the AV valves was measured to exclude or confirm its regurgitation. Postnatally the hemoglobin difference was evaluated if available and compared with sonographic findings.<\/jats:p><jats:p><jats:bold>Results.<\/jats:bold>In all cases inter-twin difference in abdominal circumference was greater than 18 mm and inter-twin weight difference of more than 15%. We observed polyhydramnios\/oligohydramnios in all twin pregnancies.<\/jats:p><jats:p>It has been found decreased PI in middle cerebral artery in larger fetus (recipient) in all our cases (comparing to single pregnancy). PI values for this vessel in smaller fetuses were within normal range (for single pregnancy). PI values in umbilical arteries of recipients were abnormal (increased PI or absent end-diastolic flow).<\/jats:p><jats:p><jats:bold>Comments.<\/jats:bold>The sonographic criteria seem to be very useful in diagnosis of twin-to-twin transfusion syndrome, especially in cases where the measurement of hemoglobin level is impossible. Doppler blood flow velocimetry in fetal vessels helps to explain the changes in fetal hemodynamics in TTTS.<\/jats:p>","DOI":"10.1017\/s0001566000000155","type":"journal-article","created":{"date-parts":[[2016,7,27]],"date-time":"2016-07-27T10:04:58Z","timestamp":1469613898000},"page":"227-237","source":"Crossref","is-referenced-by-count":2,"title":["Ultrasound in the Diagnosis of Twin-to-Twin Transfusion Syndrome \u2013 a Preliminary Report"],"prefix":"10.1017","volume":"47","author":[{"given":"M.","family":"Ropacka","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Markwitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Ginda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. H.","family":"Br\u0119borowicz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2014,8,1]]},"reference":[{"key":"S0001566000000155_ref025","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(65)80125-1"},{"key":"S0001566000000155_ref020","first-page":"1097","article-title":"Doppler umbilical artery studies in twin-twin transfusion syndrome","volume":"76","author":"Giles","year":"1990","journal-title":"Obstet Gynecol"},{"key":"S0001566000000155_ref003","first-page":"99","article-title":"Die Bedeutung von Doppler-Blutflussmessung bei Geminigraviditat","volume":"191","author":"Arabin","year":"1987","journal-title":"Z Geburtsh Perinat"},{"key":"S0001566000000155_ref023","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1542\/peds.49.1.112","article-title":"The fetoplacental circulation during parturition illustrated by the interfetal transfusion syndrome","volume":"49","author":"Klebe","year":"1972","journal-title":"Pediatrics"},{"key":"S0001566000000155_ref006","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197306142882406"},{"key":"S0001566000000155_ref028","doi-asserted-by":"publisher","DOI":"10.1159\/000263622"},{"key":"S0001566000000155_ref019","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-198812000-00017"},{"key":"S0001566000000155_ref024","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(87)90293-6"},{"key":"S0001566000000155_ref009","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.143.2.7071360"},{"key":"S0001566000000155_ref018","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1985.tb01354.x"},{"key":"S0001566000000155_ref012","first-page":"882","article-title":"Polyhydramnios and oligohydramnios in twin gestation","volume":"71","author":"Chescheir","year":"1988","journal-title":"Obstet Gynecol"},{"key":"S0001566000000155_ref013","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(89)90521-8"},{"key":"S0001566000000155_ref011","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1973.tb16049.x"},{"key":"S0001566000000155_ref030","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(79)80278-4"},{"key":"S0001566000000155_ref017","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(93)90997-N"},{"key":"S0001566000000155_ref034","first-page":"1058","article-title":"Antenatal diagnosis of twin-twin transfusion syndrome by Doppler ultrasound","volume":"78","author":"Yamada","year":"1991","journal-title":"Obstet Gynecol"},{"key":"S0001566000000155_ref007","first-page":"714","article-title":"The twin-twin transfusion syndrome","volume":"76","author":"Blickstein","year":"1990","journal-title":"Obstet Gynecol"},{"key":"S0001566000000155_ref022","first-page":"240","article-title":"Fetal urine output in hydramnios","volume":"73","author":"Kirshon","year":"1989","journal-title":"Obstet Gynecol"},{"key":"S0001566000000155_ref029","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(92)91340-G"},{"key":"S0001566000000155_ref031","first-page":"363","article-title":"Ultrasonic diagnosis of discordant fetal growth in twin gestations","volume":"69","author":"Storlazzi","year":"1987","journal-title":"Obstet Gynecol"},{"key":"S0001566000000155_ref005","first-page":"1499","article-title":"Twin placenta in perinatal mortality","volume":"61","author":"Bernischke","year":"1961","journal-title":"NY State J Med"},{"key":"S0001566000000155_ref016","first-page":"169","volume-title":"A critical appraisal of fetal surveillance","author":"Gembruch","year":"1994"},{"key":"S0001566000000155_ref026","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(83)90111-4"},{"key":"S0001566000000155_ref027","first-page":"789","article-title":"Umbilical blood wave forms in fetal surveillance of twins","volume":"153","author":"Saldana","year":"1985","journal-title":"Am J Obstet Gynecol"},{"key":"S0001566000000155_ref021","doi-asserted-by":"publisher","DOI":"10.7863\/jum.1995.14.2.101"},{"key":"S0001566000000155_ref033","first-page":"123","article-title":"Antenatal diagnosis of twin transfusion syndrome by ultrasound","volume":"58","author":"Wittmann","year":"1981","journal-title":"Obstet Gynecol"},{"key":"S0001566000000155_ref010","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.170.1.2642349"},{"key":"S0001566000000155_ref001","doi-asserted-by":"publisher","DOI":"10.1177\/000992286700600711"},{"key":"S0001566000000155_ref015","first-page":"569","article-title":"The role of velamentous cord insertion in the etiology of twin-twin transfusion syndrome","volume":"81","author":"Fries","year":"1993","journal-title":"Obstet Gynecol"},{"key":"S0001566000000155_ref014","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(85)90348-5"},{"key":"S0001566000000155_ref002","first-page":"305","article-title":"Patophysiologic mechanism of hydramnios development in twin transfusion syndrome. 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