Fetal distress and circulatory disturbance in monochorionic twins: Possible risk factors for sialadenitis?

Cerebral oxygenation reflects fetal development in preterm monochorionic and dichorionic twins

BACKGROUND

Cerebral oxygenation (crSO₂) 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 crSO₂ and blood flow patterns in this population after birth.

OBJECTIVE

To evaluate crSO₂ changes in preterm monochorionic and dichorionic twins during the first 72 h of life.

METHODS

Near-infrared spectroscopy was used to measure crSO₂ 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 crSO₂ among the subgroups using mixed model analysis (p < 0.001). The recipient twins exhibited the lowest crSO₂ (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 crSO₂ values postnatally and underlying fetal pathology in monochorionic and dichorionic preterm twins.