Amniotic fluid markers of fetal cardiac dysfunction in twin-to-twin transfusion syndrome

Tim Van Mieghem*, Elisa Doné, Léonardo Gucciardo, Philipp Klaritsch, Karel Allegaert, Rita Van Bree, Liesbeth Lewi, Jan Deprest

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

59 Citations (Scopus)


Objective: The objective of the study was to determine whether cardiac troponin T (cTnT) and natriuretic peptides can be isolated from the amniotic fluid (AF) of pregnancies complicated by twin-to-twin transfusion syndrome (TTTS) and whether they correlate with fetal echocardiographic findings and recipient survival. Study Design: AF samples from the recipient sac were obtained in 52 TTTS cases and 16 controls. Samples were assayed for cTnT and natriuretic peptides. Prior to fetoscopic laser therapy, 34 recipient twins underwent assessment of atrioventricular flow patterns, myocardial performance index (MPI), and precordial venous Dopplers. Fetal survival was assessed 48 hours postoperatively. Results: AF B-type natriuretic peptide and cTnT levels were elevated in TTTS and correlated with functional echocardiographic findings. Postoperative recipient survival was 72% when both AF-cTnT and left ventricular MPI were increased. If 1 of both markers was normal, survival was 100% (P = .046). Conclusion: Combining ultrasound and AF-cTnT measurements allows the identification of fetuses at risk of postoperative demise.

Original languageEnglish
Pages (from-to)48.e1-48.e7
JournalAmerican Journal of Obstetrics and Gynecology
Issue number1
Publication statusPublished - Jan 2010
Externally publishedYes

Bibliographical note

Funding Information:
T.V.M. is supported by the Flemish Government through a fellowship of the Instituut voor Wetenschap en Technologie (IWT 070715). The European Commission funds fellowships of E.D. and P.K. (Marie Curie Programme MEST CT2005 019707), L.G. (EuroSTEC; LSHC-CT-2006-037409), and L.L. (EuroTwin2Twin #QLG1-CT-2002-01632). J.D. and K.A. are supported by the Fund for Scientific Research, Flanders (Belgium) (F.W.O. Vlaanderen), with Fundamental Clinical Investigatorships ( and, respectively).


Dive into the research topics of 'Amniotic fluid markers of fetal cardiac dysfunction in twin-to-twin transfusion syndrome'. Together they form a unique fingerprint.

Cite this