In utero fetal oximetry via visible light spectroscopy in twin-twin transfusion syndrome

Am J Obstet Gynecol. 2008 Dec;199(6):639.e1-4. doi: 10.1016/j.ajog.2008.05.026. Epub 2008 Jul 29.

Abstract

Objective: The purpose of this study was to assess fetal tissue venous oxygenation (StO2%) in utero during laser therapy for twin-twin transfusion syndrome via visible light spectroscopy (VLS).

Study design: StO2% was measured in 10 donor and recipient twins at the level of the skin and placenta before and after laser therapy (SLPCV).

Results: Pre-SLPCV skin StO2% was significantly lower in the donor than in the recipient twin (21.6 +/- 6.2 vs 31.2 +/- 8.6, respectively; P = .01), but the difference disappeared after SLPCV. Placental surface StO2% measurements in 5 patients showed a significant increase in StO2% in the territory of the recipient (P = .04). Preoperative linear streaming as evidence of nonadmixing deoxygenated and oxygenated blood disappeared after SLPCV.

Conclusion: In utero StO2% measurement is possible with VLS. Donor twins can have significantly less StO2% than recipient twins, but this is corrected after SLPCV. Further studies are warranted to determine the value of in utero VLS oximetry.

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Fetal Development / physiology
  • Fetal Mortality / trends
  • Fetofetal Transfusion / diagnosis
  • Fetofetal Transfusion / surgery*
  • Gestational Age
  • Humans
  • Laser Coagulation / methods*
  • Oximetry / methods*
  • Oxygen Consumption / physiology
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy, Multiple
  • Prenatal Diagnosis / methods*
  • Risk Assessment
  • Sensitivity and Specificity
  • Spectrum Analysis / methods
  • Treatment Outcome
  • Twins, Monozygotic