Abstract
Background: Cerebral oxygenation (crSO(2)) monitoring is increasingly used in high-risk infants. Monochorionic twins suffer from specific fetal pathologies that can affect cerebral hemodynamics.
Limited data are available on crSO(2) and blood flow patterns in this population after birth. Objective: To evaluate crSO(2) changes in preterm monochorionic and dichorionic twins during the first 72 h of life.
Methods: Near-infrared spectroscopy was used to measure crSO(2) in 62 infants from 31 twin pregnancies< 32 weeks of gestation. The study group was divided into 4 subgroups: donor (1) and recipient (2) monochorionic twins (with twin-twin transfusion syndrome), fetal growth restriction (FGR) infants (3) and twins without fetal compromise (4).
Results: There was significant difference in birth weight (p < 0.001) among 4 subgroups. We observed significant variation in crSO(2) among the subgroups using mixed model analysis (p < 0.001).
The recipient twins exhibited the lowest crSO(2) (mean +/- SE) throughout the study period (76 +/- 0.3%), whereas the FGR and donor twins presented with the highest values (86 +/- 0.3% and 83 +/- 0.4% respectively). We found no statistically significant differences in neonatal mortality and morbidity among subgroups.
Conclusion: Our study revealed significant correlation between crSO(2) values postnatally and underlying fetal pathology in monochorionic and dichorionic preterm twins.