Acute Fetal Metabolomic Changes in Twins Undergoing Fetoscopic Surgery for Twin-Twin Transfusion Syndrome

• DOI: 10.1017/thg.2024.10
• Publication Date: 2024-03-22T06:23:15Z
• Authors: Braxton Forde; Samuel Martin; Miki Watanabe-Cha...; Foong-Yen Lim
• Keywords: Fetal Surgery; Fetoscopy; Surgical stress

Fetuses undergo major surgical stress as well fluid shifts secondary to both twin-twin transfusion (TTTS) the fetoscopic surgery for treatment of TTTS. While pathophysiology TTTS is understood, acute metabolic changes that fetuses experience from are not. We sought evaluate in recipient metabolomic profile surgery. Amniotic was collected at beginning and end four cases performed 12/2022-2/2023. Samples were immediately processed evaluated via NMR-based Metabolomics Facility protocol. In univariate analysis, 12 metabolites (glucose, lactate, 10 key amino acids) showed statistically significant between Among these, 11 decreased end, while only lactate increased. Supervised oPLS-DA modeling revealed pyruvate two most impact on variance cases, 40% could be attributed directly timing sample taken (i.e., if pre- or postoperatively). These results indicate twin during findings glucose, increased amnio acids would catabolism This study raises questions regarding optimal maternal fetal nutrition nutritional status optimized further improve survival