Mapping of placental connections in MCDA twin pregnancies v2
Research type
Research Study
Full title
Investigating the feasibility of using Doppler ultrasound imaging to map placental vasculature and anastomoses in monochorionic diamniotic (MCDA) twin pregnancies
IRAS ID
242564
Contact name
Christoph C Lees
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
0 years, 11 months, 31 days
Research summary
Twin-Twin Transfusion Syndrome (TTTS) affects 10-15% of Monochorionic diamniotic (MCDA) twins. It is the leading cause of death and disability in twins. TTTS occurs when connections between placental blood vessels (arterio-venous anastomoses, AVAs) allow unequal sharing of placental blood flow. Current management includes invasive fetoscopic laser to block AVAs. Fetoscopic laser treatments are improved by pre-mapping of AVAs.
AVAs can be found using standard Doppler imaging, but the sensitivity is at best 50% and the techniques for ultrasound identification have not been developed recently. The ability to more accurately map AVAs would also allow targeting of non-invasive methods of occluding blood vessels, such as High Intensity Focused Ultrasound, a potential novel therapy for TTTS.
In this placental mapping study, we will aim to recruit around 30 women with MCDA pregnancies in their second trimester. The study is observational with no interventions. Women will be offered up to two additional scans, where we will attempt to develop existing ultrasound techniques to map their placental vasculature. Ultrasounds will be performed by qualified medical personnel, and will not affect or replace the schedule of ultrasound recommended by national guidance on managing twin pregnancies. The results will be made available to the patient and her direct care team.
Data from this study will be used to demonstrate if it is feasible to map the placental vasculature in MCDA pregnancies.
This study will be conducted at Queen Charlotte's and Chelsea Hospital, Imperial College NHS Trust.
REC name
South Central - Berkshire Research Ethics Committee
REC reference
18/SC/0603
Date of REC Opinion
23 Oct 2018
REC opinion
Favourable Opinion