{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:00:20Z","timestamp":1790600420358,"version":"4.1.0"},"reference-count":22,"publisher":"Knowledge E DMCC","issue":"8","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":["knepublishing.com"],"crossmark-restriction":true},"short-container-title":["IJRM"],"abstract":"<jats:p>Background: Indomethacin is administered to reduce preterm labor after fetoscopic laser photocoagulation (FLP) of placental anastomoses.\r\nObjective: To compare ductus arteriosus (DA) Doppler findings in monochorionic diamniotic twin pregnancies complicated by twin-to-twin transfusion syndrome following FLP between cases treated with indomethacin and those treated with nifedipine.\r\nMaterials and Methods: In this retrospective cohort study, data of 86 pregnant women aged 17\u201341 yr who underwent FLP in Shariati hospital, Tehran, Iran from October 2024-November 2025 were extracted from medical records and then followed up. In the study, based on pulse rate, the cases were placed in one of 2 groups: nifedipine (pulse rate &lt; 100) and indomethacin (pulse rate &gt; 100) for 48 hr. In cases receiving indomethacin, 6 cases developed DA constriction. A comprehensive fetal echocardiography was performed to assess the status of the DA before and after FLP.\r\nResults: Peak systolic velocity was higher in both donor (145.7 \u00b1 32.2, p = 0.012) and recipient twins (147.2 \u00b1 23.6, p = 0.010) in the constricted group compared with the non-constricted groups. In recipient twins, end-diastolic velocity mean was also significantly increased (32.0 in the constricted, 19.9 in the indomethacin, and 18.7 in the nifedipine group, p = 0.012), while pulsatility index mean was significantly lower in the constricted group (1.8, 2.6, 2.5, respectively, p = 0.010).\r\nConclusion: DA constriction is associated with significant changes in blood flow indices, a higher incidence of right ventricular dysfunction, and a greater prevalence of valvular regurgitation. In this study, fetal DA constriction resolved during the short-term follow-up period.<\/jats:p>","DOI":"10.18502\/ijrm.v24i8.21665","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:15:30Z","timestamp":1790597730000},"update-policy":"https:\/\/doi.org\/10.18502\/knecrossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of indomethacin and nifedipine regarding ductus arteriosus Doppler findings after laser therapy for monochorionic diamniotic twin-to-twin transfusion syndrome: A retrospective cohort study"],"prefix":"10.18502","volume":"24","author":[{"given":"Sareh","family":"Mokhtari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laleh","family":"Eslamian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vajiheh","family":"Marsoosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Golbabaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nafiseh","family":"Saedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paria","family":"Boustani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7770","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"343822","doi-asserted-by":"crossref","unstructured":"[1] Miller JL. Twin to twin transfusion syndrome. Transl Pediatr 2021; 10: 1518\u20131529.","DOI":"10.21037\/tp-20-264"},{"key":"343823","doi-asserted-by":"crossref","unstructured":"[2] Sago H, Ishii K, Sugibayashi R, Ozawa K, Sumie M, Wada S. Fetoscopic laser photocoagulation for twin-twin transfusion syndrome. J Obstet Gynaecol Res 2018; 44: 831\u2013839.","DOI":"10.1111\/jog.13600"},{"key":"343824","doi-asserted-by":"crossref","unstructured":"[3] Areia AL, Mota-Pinto A. Inflammation and preterm birth: A systematic review. Reprod Med 2022; 3: 101\u2013111.","DOI":"10.3390\/reprodmed3020009"},{"key":"343825","doi-asserted-by":"crossref","unstructured":"[4] Malshe A, Snowise S, Mann LK, Boring N, Johnson A, Bebbington MW, et al. Preterm delivery after fetoscopic laser surgery for twin-twin transfusion syndrome: Etiology and risk factors. 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The ductus arteriosus: A review of embryology to intervention. Pediatr Radiol 2023; 53: 509\u2013522.","DOI":"10.1007\/s00247-022-05518-0"},{"key":"343830","doi-asserted-by":"crossref","unstructured":"[9] Mustafa HJ, Krispin E, Tadbiri H, Espinoza J, Shamshirsaz AA, Nassr AA, et al. Efficacy of long-term indomethacin therapy in prolonging pregnancy after fetoscopic laser surgery for twin-to-twin transfusion syndrome: A collaborative cohort study. BJOG 2022; 129: 597\u2013606.","DOI":"10.1111\/1471-0528.17017"},{"key":"343831","doi-asserted-by":"crossref","unstructured":"[10] Chugh BD, Makam A. Diagnosis and management of fetal Ductus arteriosus constriction. J Fetal Med 2020; 7: 235\u2013242.","DOI":"10.1007\/s40556-020-00266-3"},{"key":"343832","doi-asserted-by":"crossref","unstructured":"[11] Katsura D, Inatomi A, Tokoro S, Tsuji S, Murakami T. Changes during reopening in premature constriction or closure of the ductus arteriosus: A report of two cases. Cureus 2025; 17: e80983.","DOI":"10.7759\/cureus.80983"},{"key":"343833","doi-asserted-by":"crossref","unstructured":"[12] Chang H-Y, Locker J, Lu R, Schuster VL. Failure of postnatal ductus arteriosus closure in prostaglandin transporter-deficient mice. Circulation 2010; 121: 529\u2013536.","DOI":"10.1161\/CIRCULATIONAHA.109.862946"},{"key":"343834","doi-asserted-by":"crossref","unstructured":"[13] Baragatti B, Sodini D, Uematsu S, Coceani F. Role of microsomal prostaglandin E synthase-1 (mPGES1)-derived PGE2 in patency of the ductus arteriosus in the mouse. Pediatr Res 2008; 64: 523\u2013527.","DOI":"10.1203\/PDR.0b013e318184d29c"},{"key":"343835","doi-asserted-by":"crossref","unstructured":"[14] Hallman M, Treluyer JM, Aikio O, Roz\u00e9 J-C. Early closure mechanisms of the ductus arteriosus in immature infants. Acta Paediatr 2021; 110: 1995\u20132007.","DOI":"10.1111\/apa.15826"},{"key":"343836","doi-asserted-by":"crossref","unstructured":"[15] Pacifici GM. Clinical pharmacology of indomethacin in preterm infants: Implications in patent ductus arteriosus closure. Paediatr Drugs 2013; 15: 363\u2013376.","DOI":"10.1007\/s40272-013-0031-7"},{"key":"343837","doi-asserted-by":"crossref","unstructured":"[16] Dayer N, Ltaief Z, Liaudet L, Lechartier B, Aubert J-D, Yerly P. Pressure overload and right ventricular failure: From pathophysiology to treatment. J Clin Med 2023; 12: 4722.","DOI":"10.3390\/jcm12144722"},{"key":"343838","doi-asserted-by":"crossref","unstructured":"[17] Sharma V, Berkelhamer S, Lakshminrusimha S. Persistent pulmonary hypertension of the newborn. Matern Health Neonatol Perinatol 2015; 1: 14.","DOI":"10.1186\/s40748-015-0015-4"},{"key":"343839","doi-asserted-by":"crossref","unstructured":"[18] Soares MJ, Iqbal K, Kozai K. Hypoxia and placental development. 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