Gapp-Born Elodie, Sananes Nicolas, Guerra Fernando, Kohler Monique, Weingertner Anne Sophie, Fritz Gabrielle, Viville Brigitte, Langer Bruno, Sauleau Erik, Nisand Israël, Favre Romain
Department of Obstetrics and Gynaecology, Strasbourg University Teaching Hospital, Strasbourg, France.
Prenat Diagn. 2014 Sep;34(9):908-14. doi: 10.1002/pd.4393. Epub 2014 May 15.
The Quintero staging of twin-to-twin transfusion syndrome (TTTS) does not include a comprehensive cardiovascular assessment. The aim of this study is to assess the predictive value of the myocardial performance index (MPI) and the Children's Hospital of Philadelphia (CHOP) score on recipient survival in Quintero stages 1 and 2 TTTS.
The cohort study was based on prospectively collected data between May 2008 and February 2013 in a population of stages 1 and 2 TTTS. Comparisons between groups were carried out using Student's t-test and χ(2)-test. A stepwise ascending multivariate logistic regression model was then built.
A total of 73 pregnancies in stages 1 and 2 of Quintero's classification were treated with laser. Rates of recipient fetal losses were higher when MPI was above 0.43 ms (71.4% vs 28.6%, p = 0.022). Rate of CHOP score above 5 was higher in the fetal loss group (28.6% vs 5.1%, p = 0.022). After adjustment for Quintero stages 1 or 2, the risk of recipient loss rate is higher according to CHOP score [OR 7.6; 95% confidence interval (CI) 1.3-43.5] or MPI value (OR 3.7; 95% CI 1.0-13.9).
The CHOP score and MPI are correlated with the recipient survival in stages 1 and 2 TTTS.
双胎输血综合征（TTTS）的昆特罗分期未包括全面的心血管评估。本研究的目的是评估心肌性能指数（MPI）和费城儿童医院（CHOP）评分对昆特罗1期和2期TTTS受血儿生存的预测价值。
该队列研究基于2008年5月至2013年2月前瞻性收集的1期和2期TTTS人群的数据。组间比较采用学生t检验和χ²检验。然后建立逐步上升的多变量逻辑回归模型。
昆特罗分类1期和2期的73例妊娠接受了激光治疗。当MPI高于0.43毫秒时，受血儿胎儿丢失率更高（71.4%对28.6%，p = 0.022）。胎儿丢失组CHOP评分高于5分的比例更高（28.6%对5.1%，p = 0.022）。在对昆特罗1期或2期进行调整后，根据CHOP评分[比值比（OR）7.6；95%置信区间（CI）1.3 - 43.5]或MPI值（OR 3.7；95%CI 1.0 - 13.9），受血儿丢失率风险更高。
CHOP评分和MPI与1期和2期TTTS受血儿的生存相关。
