Establishment of a diagnostic and management method for fetal circulatory insufficiency in twin-to-twin transfusion syndrome

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K11114
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Obstetrics and gynecology
• Research Institution: Toho University
• Principal Investigator: Nakata Masahiko 東邦大学, 医学部, 教授 (10294646)
• Co-Investigator(Kenkyū-buntansha): 日根 幸太郎 東邦大学, 医学部, 助教 (50729308) ; 大路 斐子 東邦大学, 医学部, 助教 (90385641) ; 與田 仁志 東邦大学, 医学部, 教授 (90589053)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: 双胎間輸血症候群 / 超音波ドプラ法 / 超音波2Dトラッキング法 / 胎児循環

Outline of Final Research Achievements

To establish a diagnostic and management method for fetal circulatory insufficiency in twin-to-twin transfusion syndrome (TTTS), we validated the evaluation of fetal cardiac diastolic function using the ultrasound pulsed doppler method. The results showed that the Dual-gate Doppler evaluation of fetal left and right ventriclar E/e' was useful to assess the circadian function in the recipient twin in the early onset of TTTS.
We also demonstrated for the first time that an ultrasound 2D tracking system can be used to measure fractional shortening of the ventricle, which is an indicator of fetal contractility. It is hoped that this time the same method will be applied clinically.

Free Research Field

産婦人科学

Academic Significance and Societal Importance of the Research Achievements

双胎間輸血症候群は一絨毛膜双胎の約10％に発症する生命予後ないし神経学的発達予後の不良の疾患である。本研究では、双胎間輸血症候群の認められる胎児循環不全の早期診断法の探索と胎児循環の定量的な評価法の確立を目的として遂行され、Dual-gate Doppler法によるE/e'の測定や2Dトラッキング法によるfractional shorteningの計測が有用であることが世界で初めて明らかとなった。