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Human Reproduction, Vol. 14, No. 6, 1614-1618, June 1999
© 1999 European Society of Human Reproduction and Embryology

Endothelin concentrations in monochorionic twins with severe twin–twin transfusion syndrome

Rekha Bajoria1, Mark Sullivan and Nicholas M. Fisk

Imperial College of Science, Technology and Medicine, Division of Paediatrics, Obstetrics & Gynaecology, Institute of Obstetrics & Gynaecology, Queen Charlotte's & Chelsea Hospital, London, UK

The objective of this study was to determine endothelin (ET-1) concentrations in monochorionic twin fetuses with and without twin–twin transfusion syndrome (TTTS). Fourteen monochorionic twin pregnancies complicated by TTTS and six without TTTS were studied. Matched maternal and fetal blood samples were obtained both in utero and at birth. Amniotic fluid samples were also collected from twin pairs. ET-1 concentrations were measured by radio-immunoassay. ET-1 concentrations in recipient fetuses were higher than in the donors both in utero(P < 0.001) and at birth (P < 0.01). Fetal concentrations of ET-1 in donors were similar to non-TTTS twins. Plasma ET-1 concentrations were significantly higher (P < 0.01) in recipient fetuses with severe hydrops than those with mild/no hydrops. Maternal concentrations of ET-1 were comparable in the two groups. Endothelin concentrations in recipient twins were 21/2 times higher than in their co-twins and this was related to the severity of hydrops.

Key words: endothelin-1/fetal cardiac dysfunction/twin–twin transfusion syndrome

1 To whom correspondence should be addressed at: St Mary's Hospital for Women and Children, Department of Obstetrics and Gynaecology, Whitworth Park, Manchester M13 OJH, UK


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