<scp>P</scp>19.01: Fetal hemodynamic parameters in monochorionic diamniotic twin pregnancies complicated with twin–twin transfusion syndrome treated by laser photocoagulation
Bibliographic record
Abstract
To determine the prognostic value of fetal echocardiography for twin-twin transfusion syndrome (TTTS) using the CHOP (Children's Hospital of Philadelphia) cardiovascular score in correlation with the Quintero staging. To evaluate whether hemodynamic changes, pre and post laser photocoagulation, predict the neonatal survival. Hemodynamic parameters of 90 pregnancies with TTTS were collected pre and post laser photocoagulation. The cardiac function parameters were compared to 90 uncomplicated monochorionic diamniotic twin pregnancies. Between 2006 and 2013, 90 laser photocoagulations were performed. Quintero staging was divided between stage 1 (11%), 2 (39%), 3 (49%) and 4 (1%). Fetal echocardiography was available in 82 cases but pre and post laser intervention in only 69 cases. Neonatal survival rates were 19%, 22% and 59% for zero, one or two twins respectively. At least one twin was delivered alive in 81% of the pregnancies. The mean gestational age at surgery was 20 weeks (range 15-25). The mean age at birth in cases with at least one live birth was 32 weeks (range 24-38). The following factors were not associated with neonatal survival: placental location, Quintero staging, gestational age at diagnosis, amnioreduction volume. The preoperative myocardial performance index (MPI) was higher in the recipient than in the donor twin (0.58 vs 0.37, p < 0.001). In healthy monochorionic twins MPI was 0.43 (right ventricle) and 0.37 (left ventricle), and the CHOP cardiovascular score was 1.8. The mean CHOP score was 4.8 preoperatively and 3.3 postoperatively (p <0.001, paired t test). The CHOP score was not related to neonatal survival. Our study confirmed a correlation between the Quintero staging and the CHOP cardiovascular score. However, both tests showed no prognostic value in predicting neonatal survival rates. Discrepancies in hemodynamic parameters between TTTS and controls and between donor and recipient twin are evidenced by fetal echocardiography.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".