Rychik et al developed a score for evaluating cardiovascular abnormalities in fetuses affected by the twin-twin transfusion syndrome. The authors are from the Children’s Hospital of Philadelphia.
Patient selection: fetuses with a twin-twin transfusion syndrome
Parameters for recipient
(1) ventricular hypertrophy
(2) cardiomegaly
(3) ventricular function
(4) mitral valve regurgitation
(5) tricuspid valve regurgitation
(6) mitral valve infow
(7) tricuspid valve flow
(8) ductus venosus
(9) pulsatile umbilical vein
(10) pulmonary valve regurgitation
(11) right ventricular outflow tract (RVOT)
Paramter for donor:
(1) diastolic flow in the umbilical artery
|
Parameter |
Finding |
Points |
|
recipient’s ventricular hypertrophy |
absent |
0 |
|
|
present |
1 |
|
recipient’s cardiac dilatation |
none |
0 |
|
|
mild |
1 |
|
|
moderate to severe |
2 |
|
recipient’s ventricular function |
normal |
0 |
|
|
mild dysfunction |
1 |
|
|
moderate to severe dysfunction |
2 |
|
recipient’s mitral valve regurgitation |
none |
0 |
|
|
mild |
1 |
|
|
moderate to severe |
2 |
|
recipient’s tricuspid valve regurgitation |
none |
0 |
|
|
mild |
1 |
|
|
moderate to severe |
2 |
|
recipient’s mitral valve inflow |
double peak |
0 |
|
|
single peak |
1 |
|
recipient’s tricuspid valve inflow |
double peak |
0 |
|
|
single peak |
1 |
|
ductus venosus |
antegrade |
0 |
|
|
absent diastolic blood flow |
1 |
|
|
reverse diastolic blood flow |
2 |
|
pulsatile umbilical vein |
no |
0 |
|
|
yes |
1 |
|
pulmonary valve regurgitation |
no |
0 |
|
|
yes |
1 |
|
right ventricular outflow tract |
pulmonary artery > aorta |
0 |
|
|
pulmonary artery = aorta |
1 |
|
|
pulmonary artery < aorta |
2 |
|
|
RVOT obstruction |
3 |
|
donor’s umbilical artery |
normal diastolic flow |
0 |
|
|
decreased diastolic flow |
1 |
|
|
absent or reverse diastolic flow |
2 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
Specialty: Pedatrics
ICD-10: ,
