Prediction of Perinatal Outcomes for Cardiac Dysfunction in Monochorionic Di-amniotic Twin Pregnancies Based on Information Model
- VernacularTitle:基于信息量模型的单绒毛膜双羊膜囊双胎心脏功能异常围产结局预测
- Author:
Han ZHANG
1
;
Yuan WEI
;
Yangyu ZHAO
Author Information
1. 北京医院妇产科 国家老年医学中心 中国医学科学院老年医学研究院,北京 100730;北京大学第三医院妇产科国家妇产疾病临床医学研究中心,北京 100191
- Keywords:
Fetal echocardiography;
Cardiac dysfunction;
Information model;
Monochorionic diamniotic twin pregnancy;
Perinatal outcome
- From:
Journal of Practical Obstetrics and Gynecology
2024;40(7):547-553
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the characteristics of fetal cardiac dysfunction in monochorionic diamniotic(MCDA)twin pregnancies,and establish a prediction model for their perinatal outcomes mainly based on ultra-sound indicators using information method.Methods:A total of 104 twin cases with ultrasound indicating fetal heart abnormalities were selected.Based on their chorionic and fetal heart abnormalities,they were divided into three groups:MCDA dysfunction group(61 cases),MCDA structural abnormalities group(23 cases),and dichori-onic diamniotic(DCDA)structural abnormalities group(20 cases).The clinical features of the three groups were analyzed and compared,and clinical outcomes were followed up until 3 years postpartum.A perinatal outcome prediction model for fetal cardiac dysfunction was established using the information method.All ultrasound abnor-mal indicators(7 categories)from the MCDA functional abnormality group,as well as 3 common clinical indicators,were included in the information model calculation.At the same time,the effectiveness of the model prediction was evaluated using receiver operating characteristic(ROC)curves and reserved cases(5 cases).Results:① Com-pared with the group with MCDA structural abnormalities,the group with MCDA functional abnormalities had a higher proportion of twin specific complications and a more severe staging.There was no statistically significant difference(P>0.05)in the proportion of live and non-live birth among the three groups,as well as the differences between different live birth outcomes and non-live birth outcomes.However,follow-up found that the majority(22/24)of live births in the MCDA dysfunction group had their heart function returning to normal on their own.②The pre-diction results of the information model showed that the classification criteria for adverse perinatal outcome or risks(I)of fetal cardiac dysfunction were:when I>1.0,the risk of fetal death was high;when-1.0
