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

2009 ◽  
Vol 29 (3) ◽  
pp. 253-256 ◽  
Author(s):  
Yao-Lung Chang ◽  
Shuenn-Dyh Chang ◽  
An-Shine Chao ◽  
Peter C. C. Hsieh ◽  
Chao-Nin Wang ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Monochorionic Twin ◽  
Intrauterine Growth ◽  
Different Types ◽  
Umbilical Artery Doppler ◽  
Twin Pregnancies

scholarly journals The comparison of the perinatal outcomes in monochorionic twin pregnancies with and without selective intrauterine growth restriction

2021 ◽  
Vol 29 (1) ◽  
pp. 20-26
Author(s):  
Elif Fide Pişirgen ◽  
Münip Akalın ◽  
Oya Demirci ◽  
Pınar Kumru ◽  
Emine Eda Akalın
Keyword(s):  
Flow Pattern ◽  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Monochorionic Twin ◽  
Intrauterine Growth ◽  
Increased Risk ◽  
Artery Flow ◽  
Twin Pregnancies

Objective Both fetuses may be affected negatively as a result of the non-equal share of the placenta and vascular anastomoses in monochorionic pregnancies with selective intrauterine growth restriction (sIUGR). In our study, we aimed to investigate the perinatal outcomes of both larger and smaller fetuses in monochorionic pregnancies with and without sIUGR (non-sIUGR) separately. Methods A total of 196 monochorionic twin pregnancies were evaluated retrospectively between January 2013 and January 2019. The cases were grouped as sIUGR and non-sIUGR pregnancies. The pregnancies with sIUGR were also separated into sub-groups as the cases with normal umbilical flow pattern and the cases with abnormal umbilical flow pattern. The perinatal outcomes were investigated separately between the groups for larger and smaller fetuses. Results Of 153 monochorionic pregnancies included in the study, 17.6% (n=27) were sIUGR cases and 82.4% (n=126) were non-sIUGR cases. While the umbilical artery flow pattern was normal in 59.3% (n=16) of the pregnancies which developed sIUGR, 40.7% (n=11) of them had abnormal umbilical artery flow pattern. The preeclampsia rate was found significantly higher in sIUGR pregnancies than non-sIUGR pregnancies (25.9% vs. 11.1%, p=0.042). The need for intensive care for both larger and smaller newborns was significantly higher in sIUGR pregnancies compared to non-sIUGR pregnancies (p<0.001). Three (11.1%) of newborns in sIUGR pregnancies passed away during neonatal period. All of the newborns that passed away were the smaller newborns from sIUGR pregnancies with abnormal umbilical artery flow pattern. Conclusion The pregnancies with selective intrauterine growth restriction (sIUGR) are more associated with high risks in terms of perinatal outcomes compared to the pregnancies with non-sIUGR. In pregnancies developing sIUGR, the risk increases for larger fetus as well as smaller fetus. More prospective studies are needed to investigate whether this increased risk in the pregnancies with sIUGR is associated with prematurity which is more common or is a result of sIUGR.

Perinatal Outcome of Selective Intrauterine Growth Restriction in Monochorionic Twins: Evaluation of a Retrospective Cohort in a Developing Country

2021 ◽  
pp. 1-5
Author(s):  
Carolina Aquino ◽  
Ana Elisa Rodrigues Baião ◽  
Paulo Roberto Nassar de Carvalho
Keyword(s):  
Intrauterine Growth Restriction ◽  
Retrospective Cohort ◽  
Umbilical Artery ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Type I ◽  
Monochorionic Twin ◽  
Intrauterine Growth ◽  
Twin Pregnancies ◽  
Estimated Fetal Weight

Abstract Selective intrauterine growth restriction (sIUGR) in monochorionic twin pregnancies is associated with greater morbidity and mortality for both fetuses when compared to singleton and dichorionic pregnancies. This retrospective cohort study aimed to assess the perinatal outcomes of monochorionic twin pregnancies affected by this disorder and conducted expectantly, by analyzing the results according to the end-diastolic flow in the umbilical artery Doppler of the smaller twin (type I: persistently forward/type II: persistently absent or reversed/type III: intermittently absent or reversed). Seventy-five monochorionic diamniotic twin pregnancies with sIUGR were included in this study. sIUGR was defined by estimated fetal weight below the 3rd centile for gestational age, or below the 10th centile, when associated with at least one of the following three criteria: abdominal circumference below the 10th percentile, umbilical artery pulsatility index of the smaller twin above the 95th percentile, or estimated fetal weight discordance of 25% or more. Perinatal outcomes were analyzed from the prenatal period to hospital discharge and included perinatal death, neurological injury, retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and sepsis. The mortality rate was 1.33% in this cohort. The overall morbidity rate was lower in type I twin pregnancies. In conclusion, this study shows that sIUGR type I has lower morbidity than types II and III in expectant management.

scholarly journals Intrauterine growth restriction in monochorionic-diamniotic twins

2014 ◽  
Vol 60 (6) ◽  
pp. 585-590 ◽  
Author(s):  
Rita de Cássia Alam Machado ◽  
Maria de Lourdes Brizot ◽  
Seizo Miyadahira ◽  
Rossana Pulcineli Vieira Francisco ◽  
Vera Lúcia Jornada Krebs ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Neonatal Morbidity ◽  
Growth Restriction ◽  
Fetal Malformation ◽  
Doppler Velocimetry ◽  
Intrauterine Growth ◽  
Study Results ◽  
Umbilical Artery Doppler ◽  
Twin Pregnancies

Objective: to evaluate neonatal morbidity and mortality in monochorionic- -diamniotic (MCDA) twin pregnancies complicated by selective intrauterine growth restriction (sIUGR) and non-selective intrauterine growth resctriction (nsIUGR). Methods: neonatal morbidity parameters and mortality were analyzed in 34 twins with IUGR (< 10th percentile on twins’ growth charts): 18 with sIUGR and 16 with nsIUGR. The sIUGR group was made up of 18 pregnancies in which growth was restricted in only one fetus (n = 18). The nsIUGR group was composed of 8 pregnancies in which both fetuses presented restricted growth (n = 16). Cases of twin-to-twin transfusion syndrome and fetal malformation were not included in the study. Results: the MCDA twin pregnancies with sIUGR had a higher rate of orotracheal intubation (p = 0.001) and mechanical ventilation (p = 0.0006), as well as longer than average fasting time (p = 0.014) compared to those in which the fetuses had nsIUGR. A higher incidence was also observed of types II and III umbilical artery Doppler velocimetry patterns in the sIUGR cases (p = 0.002). There was no significant difference between the two groups as to mortality during pregnancy and the neonatal period (p = 0.09). Conclusion: in MCDA twin pregnancies, sIUGR presents more severe umbilical artery Doppler velocimetry abnormalities and worse morbidity than nsIUGR.

scholarly journals Early Uterine and Umbilical Artery Doppler Indices as Predictor for Preeclampsia and Intrauterine Growth Restriction

2021 ◽  
pp. 116-126
Author(s):  
Sara E. Khalil ◽  
Mohammed M. Elnamory ◽  
Mona K. omar ◽  
Hesham M. Eltokhy
Keyword(s):  
Gestational Age ◽  
Predictive Value ◽  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Doppler Study ◽  
Significant Difference ◽  
Umbilical Artery Doppler ◽  
Doppler Indices

Background: Preeclampsia (PE) is a disorder that causes hypertension and proteinuria after week 20 of pregnancy. Several Uterine Artery (UtAs) Doppler characteristics have been investigated for their ability to predict PE. The purpose of this research is to look into the uterine and umbilical arterial Doppler indices in the early second trimester for the prediction of late preeclampsia or intrauterine growth restriction. Methods: This is a prospective cohort clinical study and was done at Obstetrics and Gynecology department, faculty of medicine Tanta university hospital from January 2020 till April 2021. 150 pregnant women aged from 18 to 30 years old with gestational age from 13 to 16 weeks of pregnancy. Study was done by the same observer by machine MINDRAY DC60 Measurement of fetal biometry (BPD, FL, AC, HC) Gestational age was confirmed with Detection of congenital malformation.    Results: There is a significant difference between the groups regarding uterine and umbilical artery doppler Indices. Uterine RI only yielded significance for predicting IUGR with sensitivity of 62% and specificity of 88%, with Positive predictive value (PPV) 37% and Negative predictive value (NPV) 92%. Umbilical resistance index achieved sensitivity of 56% and specificity of 82%, with PPV 31% and NPV 30% with on statistical significance. Conclusions: Combination of uterine and umbilical artery Doppler study in early pregnancy is one of the best indicator for prediction of preeclampsia and IUGR. Therefore, Doppler study may be used for the prediction of preeclampsia and IUGR to reduce the maternal and perinatal morbidity and mortality.

scholarly journals Monochorionic twin pregnancies increases perinatal risk and is a high risk factor of selective intrauterine growth restriction

2019 ◽  
Author(s):  
Jie Chen ◽  
Yue Lian Yang
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Intrauterine Growth Restriction ◽  
Growth Restriction ◽  
Prenatal Health ◽  
Monochorionic Twin ◽  
Intrauterine Growth ◽  
High Risk Factor ◽  
Twin Pregnancies

Abstract Background Twins pregnancy can cause a lot of disease, especially monochorionic twin pregnancies, the prenatal infant will have many diseases and have high mortality rate. According to analysis and compare of the twin pregnancy, especially pregnant woman and puerpera’s situation and complication and baby’s situation; we hope we can find the reason which causes the fetus growth restrain of monochorionic twin pregnancies. So we can provide some reference for the prenatal health care, complication prevention and prenatal outcome. Methods We divided 489 cases of twin pregnancies into two groups: monochorionic twin and dichorionic twin and compared the clinical features of them. At last, we used the logistic regression analysis method to analyze the risk factors of selective intrauterine growth restriction(sIUGR). Results The incidences of premature rupture of membranes and sIUGR were significant higher in monochorionic twin and twin-twin transfusion syndrome (TTTS) only exists in monochorionic twin. The weight of the newborn babies(both big and small babies)were significant lower in Monochorionic twin. The neonatal transfer rate was significant higher in monochorionic twin. Gestational weeks and weight of newborn babies are the high risk factors of sIUGR. Conclusions The type of chorion has a great influence to the pregnant period and the ending of maternal women. Monochorionic is a high risk factor of the sIUGR, which means that the main cause of sIUGR is from placenta, so it is a kind of “placental origin disease”.

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