Intrauterine growth restriction in monochorionic twins

Summary Intrauterine growth restriction (IUGR) occurs in approximately 3–10% of singleton pregnancies, in 9.1% of all twins, and in 9.9% of monochorionic twins. Spontaneous demise of the IUGR twin may occur and may result in concomitant demise or severe neurological handicap of the other twin. Curre...

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Bibliographic Details
Published in:Seminars in fetal & neonatal medicine 2007-12, Vol.12 (6), p.439-449
Main Authors: Russell, Zoi, Quintero, Rubén A, Kontopoulos, Eftichia V
Format: Article
Language:English
Subjects:
Blood Vessels - embryology
Delivery, Obstetric
Diseases in Twins - surgery
Female
Fetal Death
Fetal Growth Retardation - surgery
Fetofetal Transfusion - surgery
Humans
Infant, Newborn
Infant, Newborn, Diseases - prevention & control
Intrauterine growth restriction
Laser therapy
Ligation
Light Coagulation
Neonatal and Perinatal Medicine
Pregnancy
Pregnancy Outcome
Pregnancy Reduction, Multifetal - methods
Twins, Monozygotic
Twin–twin transfusion syndrome
Ultrasound
Vascular Surgical Procedures
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Summary:Summary Intrauterine growth restriction (IUGR) occurs in approximately 3–10% of singleton pregnancies, in 9.1% of all twins, and in 9.9% of monochorionic twins. Spontaneous demise of the IUGR twin may occur and may result in concomitant demise or severe neurological handicap of the other twin. Currently, monochorionic twins with selective IUGR (SIUGR) are managed expectantly. Alternatively, all adverse consequences resulting from the potential demise of the SIUGR twin could be averted by unlinking the circulations between the two fetuses. The latter can be achieved by laser photocoagulation of communicating vessels or by umbilical-cord occlusion. The purpose of this chapter is to review this important entity in obstetrics.
ISSN:1744-165X
1878-0946
DOI:10.1016/j.siny.2007.06.004