Clinical outcome and placental territory ratio of monochorionic twin pregnancies and selective intrauterine growth restriction with different types of umbilical artery Doppler

• Published in: Prenatal diagnosis 2009-03, Vol.29 (3), p.253-256
• Main Authors: Chang, Yao-Lung, Chang, Shuenn-Dyh, Chao, An-Shine, Hsieh, Peter C. C., Wang, Chao-Nin, Wang, Tzu-Hao
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Case-Control Studies; Delivery. Postpartum. Lactation; Female; Fetal Growth Retardation - diagnostic imaging; Fetofetal Transfusion - diagnostic imaging; Fundamental and applied biological sciences. Psychology; Genetics of eukaryotes. Biological and molecular evolution; Gynecology. Andrology. Obstetrics; Humans; intrauterine growth restriction; Medical sciences; Molecular and cellular biology; monochorionic twin pregnancy; Placenta - pathology; Pregnancy; Prospective Studies; Twins, Monozygotic; Ultrasonography, Prenatal; Umbilical Arteries - diagnostic imaging; umbilical artery Doppler and placenta territory
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.2193

Objective To evaluate the clinical outcome and placental territory ratio in monochorionic diamniotic (MCDA) twin pregnancies and selective intrauterine growth restrictions (sIUGR) with different types of umbilical artery (UA) Doppler. Study Design An MCDA twin pregnancy with sIUGR was defined as a fetal weight below the 10th percentile in one twin. MCDA twins were divided into three groups: without IUGR (group I); with sIUGR, and a normal UA Doppler (group II); or an abnormal UA Doppler (persistent absence or reverse of end‐diastolic velocity) (group III). Placental territory was calculated as the estimated individual placental mass/total placenta weight. Results Altogether, 27 cases of group I, 11 cases of group II and 13 cases of group III MCDA twins were included. The placenta territory of the IUGR twin in group III MCDA twin was the smallest among the three groups of MCDA twins (ANOVA test, p < 0.001). There was incidence of neonatal death in six (6/26) of group III MCDA fetuses, while none in groups I and II MCDA twins did. Conclusions In MCDA twins with sIUGR, abnormal UA Doppler in the IUGR twin may reflect a more severe unequal placenta share and poorer neonatal outcomes. The prognosis of group II MCDA twins, even with sIUGR found in early gestation, is, by contrast, better. Copyright © 2009 John Wiley & Sons, Ltd.