Conclusions
Collectively, our observations indicate that the estimation of intertwin
differences in vascular impedance to umbilical artery blood supersedes
the Quintero staging in the prediction of double infant survival in TTTS
cases. DUAPI <0.4 is associated with a three-fold increase in
double infant survival to 30 days of life in cases undergoing laser
photocoagulation of placental anastomoses for the management of TTTS
cases with Quintero stages I and II as well as in those with Quintero
stages III and IV. Intertwin differences in the umbilical artery
pulsatility index may provide novel metrics to evaluate the progression
and severity of TTTS cases requiring laser surgery.
Disclosure of Interests and Contribution to Authorship:
We confirm that all authors including JE, MAB, AAS, AAS, MSC, RD,
AFE,TGO, RMJ, CH, HO and OT have met the conditions of authorship.
We confirm that all authors including JE, MAB, AAS, AAS, MSC, RD,
AFE,TGO, RMJ, CH, HO and OT declared no conflicts of interests with this
manuscript.
Details of ethics approval: The study received approval from the Baylor
College of Medicine Institutional Review Board and University Of
Maryland School Of Medicine (H-19834, H-36458 and HP-00040715-12).
Funding: Baylor College of Medicine (BCM), internal funding
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