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Doppler Umbilical Artery Studies in the Twin-Twin Transfusion Syndrome

From the Fetal Welfare Laboratory, Department of Obstetrics and Gynecology, University of Sydney at Westmead Hospital, Westmead, New South Wales, Australia

Abstract

Eleven patients with twin pregnancies were identified as having twin-twin transfusion syndrome on the basis of like-sex twins with monochorionic placentation and umbilical venous blood hemoglobin differences exceeding 50 g/L at delivery. Umbilical artery velocity-time waveform studies had been performed in these pregnancies as part of a large series of 456 twin pregnancies. In all 11 cases, the systolicdiastolic (S-D) ratio differences between the twins were less than 1 unit (mean 0.4 ± 0.2), indicating that in twin-twin transfusion, umbilical artery S-D ratios are concordant even in the presence of discordancy in fetal size.