Persistent pulmonary hypertension of the newborn in twin–twin transfusion syndrome following fetoscopic laser surgery

Abstract

Objective: We investigated persistent pulmonary hypertension of the newborn (PPHN) among monochorionic-diamniotic (MD) twins. Methods: A retrospective cohort study examined MD twins from 195 deliveries and 373 live-born neonates at our center. Results: PPHN occurred in three cases (3/373: 0.8%), all of which were recipients of twin–twin transfusion syndrome (TTTS), after fetoscopic laser surgery (FLS) (3/117: 2.6%). Although the clinical course of the three cases differed, all cardiothoracic area ratios exceeded 40%, and other cardiac parameters also worsened after FLS. Conclusions: The occurrence of PPHN in TTTS recipients should be noted, particularly when fetal cardiac function declines following FLS.

Keywords::

• Cardiac enlargement
• monochorionic-diamniotic twin
• persistent pulmonary hypertension of the newborn
• recipient
• twin–twin transfusion syndrome

Declaration of interest: The authors declare no conflicts of interest.