The effect of chorionicity on maternal hemodynamics in uncomplicated twin pregnancies
10.3969/j.issn.1672-8467.2024.05.011
- VernacularTitle:绒毛膜性对无并发症双胎妊娠孕妇血流动力学的影响
- Author:
Qi CAI
1
;
Shu-Dao WU
;
Jin-Lian XIANG
;
Yun-Yun REN
Author Information
1. 复旦大学附属妇产科医院超声科 上海 200011
- Keywords:
twin pregnancy;
chorionicity;
maternal hemodynamics;
echocardiography
- From:
Fudan University Journal of Medical Sciences
2024;51(5):718-724
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the changes of hemodynamics in pregnant women with uncomplicated dichorionic(DC)twin pregnancy and monochorionic(MC)twin pregnancy,so as to better perform prenatal monitoring.Methods A study was conducted to collect 64 pregnant women with uncomplicated twin pregnancy(41 cases of DC and 23 cases of MC)in the Obstetrics and Gynecology Hospital,Fudan University from May 2020 to Sept 2021,and 144 pregnant women with uncomplicated singleton pregnancies in the same period were selected as the control group.During the second trimester(20-28 weeks),conventional echocardiography was performed in pregnant women,and singleton pregnancy was used as the control.The left ventricular systolic,left ventricular diastolic,hemodynamic and cardiac structural parameters of DC and MC twin pregnancy were studied.Results At 20-28 weeks of gestation,compared with singleton pregnancies,the heart rate,mean arterial pressure,cardiac output,cardiac index,stroke volume,left ventricular mass,stroke work index parameters of twin pregnancy were significantly increased,and the total vascular resistance was significantly decreased,and the differences were statistically significant(P<0.05).The distribution of maternal hemodynamic parameters was similar in pregnant women with DC twin and MC twin pregnancy.Compared with DC twin pregnancy,MC twin pregnancy showed a significant increase in cardiac output(5.76 L/min vs.5.36 L/min,P=0.031).Total vascular resistance significantly decreased(1 270 vs.1 407,P=0.037).Conclusion Compared with singleton pregnancy,the hemodynamics of twin pregnancy significantly changed,which ensured the growth and development of the fetus by providing sufficient uteroplacental circulation.The cardiovascular adaptation patterns of DC and MC twin pregnancy were similar,but MC twin pregnancy had higher cardiac output and lower total vascular resistance.Monitoring the cardiac function of twin pregnancy,especially MC twin pregnancy,is very important for the safety of pregnant women.
