N-terminal Pro-brain Natriuretic Peptide Levels in Monochorionic Diamniotic Twins with Twin-to-twin Transfusion Syndrome Treated by Fetoscopic Laser Photocoagulation
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概要
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Twin-to-twin transfusion syndrome (TTTS) affects 15% of monochorionic diamniotic (MD) twin pregnancies, and is associated with adverse perinatal outcome. Recently, fetoscopic laser photocoagulation (FLP) has been widely accepted as the most definitive therapy to treat TTTS. N-terminal pro-brain natriuretic peptide (NT-proBNP) is a powerful diagnostic marker of cardiac dysfunction in neonates, and is elevated in MD twins with TTTS. However, there are no reports assessing the effect of FLP on neonatal cardiac overload in TTTS by measuring the serum NT-proBNP levels at birth. Here, we aimed to compare serum NT-proBNP levels at birth in MD twins with TTTS treated with FLP or not. Twelve MD twin pairs with TTTS admitted to our center between October 2007 and September 2012 were enrolled in this study. The MD twin pairs were separated into two groups: seven twins (12 newborn infants) with FLP (FLP group) and five twins (nine newborn infants) without FLP (non-FLP group). Gestational age, birthweight, and Apgar scores were significantly higher in the FLP group than that in the non-FLP group. Serum NT-proBNP levels at birth were significantly lower in the FLP group than in the non-FLP group [1425 pg/ml (range, 466–9560) vs. 29900 pg/ml (range, 7300–77900), respectively; p=0.0003]. The serum NT-proBNP levels of larger and smaller co-twins were significantly correlated with each other (r=0.750; p=0.026). In conclusion, serum NT-proBNP levels at birth are lower in MD twins with TTTS after FLP treatment than in those without FLP.
- 2013-00-00
著者
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藤岡 一路
加古川市民病院 小児科
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Sakai Hitomi
Department Of Dermatology National Defence Medical College
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Nakao Hideto
Department Of Neonatology Hyogo Children's Hospital Perinatal Center
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Yoshimoto Seiji
Department Of Pediatrics Kobe University School Of Medicine
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Mizobuchi Masami
Department Of Neonatology Hyogo Prefectural Kobe Children's Hospital Perinatal Center
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FUJIOKA Kazumichi
Department of Pediatrics, Kobe University Graduate School of Medicine
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Tanaka Satoshi
Department Of Agricultural Chemistry Faculty Of Agriculture Tottori University
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Wada Keiko
Department Of Epidemiology & Preventive Medicine Gifu University Graduate School Of Medicine
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Iwatani Sota
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center
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Fujioka Kazumichi
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center
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Wada Keiko
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center
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Yoshimoto Seiji
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center
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Tanaka Satoshi
Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center
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Fujioka Kazumichi
Department of Neonatology Hyogo Prefectural Kobe Children's Hospital
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Iwatani Sota
Department of Neonatology Hyogo Prefectural Kobe Children's Hospital
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Yoshimoto Seiji
Department of Neonatology Hyogo Prefectural Kobe Children's Hospital
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Mizobuchi Masami
Department of Neonatology Hyogo Prefectural Kobe Children's Hospital
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