Význam změn tkáňové oxygenace u monochoriálních dvojčat v predikci závažné neonatální morbidity

Korček, Peter

Despite improvements in perinatal outcome in recent decades, multiple pregnancies are associated with increased risk of complications including preterm birth, fetal growth restriction (FGR) and twin-twin transfusion syndrome (TTTS). Fetal circulatory disturbances and immature cerebral vasculature increase the risk for serious perinatal injury and adverse neurodevelopmental outcome in multiple births. Cerebral oxygenation (crSO2) monitoring using near-infrared spectroscopy (NIRS) is increasingly used in high-risk infants. However, limited data are available in twin preterm infants with respect to cerebral tissue perfusion. The aim of this project was to measure crSO2 using NIRS in preterm monochorionic and dichorionic twins during the first 72 hours of life and find out correlation between underlying fetal conditions and crSO2 development. We divided the study population into 4 subgroups based on major fetal pathology: donor (1) and recipient (2) monochorionic twins (with TTTS), selective FGR infants (3) and twins without fetal compromise (4). We observed significant variation in crSO2 among the subgroups using mixed model analysis. The recipient twins exhibited the lowest crSO2 throughout the study period, whereas the FGR and donor twins presented with the highest values. Nevertheless, we found no...

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