Changes in structural brain development after selective fetal growth restriction in monochorionic twins

2021 ◽  
Author(s):  
S. G. Groene ◽  
L. S. Vries ◽  
F. Slaghekke ◽  
M. C. Haak ◽  
B. T. Heijmans ◽  
...  
Keyword(s):  
Brain Development ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Monochorionic Twins ◽  
Structural Brain

DIAGNOSIS AND MANAGEMENT OF SELECTIVE FETAL GROWTH RESTRICTION IN MONOCHORIONIC TWINS

2009 ◽  
Vol 20 (4) ◽  
pp. 269-281 ◽  
Author(s):  
EDUARD GRATACÓS ◽  
ELISENDA EIXARCH ◽  
FATIMA CRISPI
Keyword(s):  
Fetal Growth ◽  
Common Sense ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Monochorionic Twins ◽  
Normal Ranges ◽  
Estimated Fetal Weight ◽  
Simple Definition

Selective fetal growth restriction (sFGR) has been reported to occur in about 10–15% of monochorionic (MC) twins. The diagnosis of sFGR has been based on variable criteria including estimated fetal weight (EFW), abdominal circumference and/or the degree of fetal weight discordance. Recent studies tend to use a simple definition which includes the presence of an EFW less than the 10th percentile in the smaller twin. Some would argue that the intertwin fetal weight discordance should be included in the definition. Indeed this factor plays a major role in the complications presented by these cases. While the majority of cases with one fetus below the 10th percentile usually will also present with a large intertwin EFW discordance, the contrary is not always true. Thus, it is possible to find MC twins with remarkable intertwin EFW discordance but the EFW of both fetuses are still within normal ranges. Although it appears to be common sense that a large intertwin discrepancy might represent a higher risk for some of the complications described later in this review, there is no consistent evidence to support this notion. Therefore, due to its simplicity, a definition based on an EFW below 10th percentile in one twin is probably the most useful for clinical and research purposes.

Clinical Outcome and Management of Selective Fetal Growth Restriction in Monochorionic Twins

Fetal Therapy ◽  
2019 ◽  
pp. 392-397
Author(s):  
Mar Bennasar ◽  
Elisenda Eixarch ◽  
Josep Maria Martinez ◽  
Eduard Gratacós
Keyword(s):  
Clinical Outcome ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Monochorionic Twins

Critical Coarctation of the Aorta in Selective Fetal Growth Restriction and the Role of Coronary Stent Implantation

2020 ◽  
Vol 47 (10) ◽  
pp. 740-748
Author(s):  
Manon Gijtenbeek ◽  
Monique C. Haak ◽  
Arend D.J. ten Harkel ◽  
Regina Bökenkamp ◽  
Benedicte Eyskens ◽  
...  
Keyword(s):  
Birth Weight ◽  
Fetal Growth ◽  
Stent Implantation ◽  
Fetal Growth Restriction ◽  
Heart Defects ◽  
Coarctation Of The Aorta ◽  
Growth Restriction ◽  
Monochorionic Twins ◽  
Coronary Stent Implantation ◽  
Increased Risk

<b><i>Introduction:</i></b> Monochorionic twins are at increased risk of congenital heart defects (CHDs). Up to 26% have a birth weight &#x3c;1,500 g, a CHD requiring neonatal surgery, therefore, poses particular challenges. <b><i>Objective:</i></b> The aim of the study was to describe pregnancy characteristics, perinatal management, and outcome of monochorionic twins diagnosed with critical coarctation of the aorta (CoA). <b><i>Methods:</i></b> We included monochorionic twins diagnosed with critical CoA (2010–2019) at 2 tertiary referral centers, and we systematically reviewed the literature regarding CoA in monochorionic twins. <b><i>Results:</i></b> Seven neonates were included. All were the smaller twin of pregnancies complicated by selective fetal growth restriction. The median gestational age at birth was 32 weeks (28–34). Birth weight of affected twins ranged as 670–1,800 g. One neonate underwent coarctectomy at the age of 1 month (2,330 g). Six underwent stent implantation, performed between day 8 and 40, followed by definitive coarctectomy between 4 and 9 months in 4. All 7 developed normally, except for 1 child with neurodevelopmental delay. Three co-twins had pulmonary stenosis, of whom 1 required balloon valvuloplasty. The literature review revealed 10 cases of CoA, all in the smaller twin. Six cases detected in the first weeks after birth were treated with prostaglandins alone, by repeated transcatheter angioplasty or by surgical repair, with good outcome in 2 out of 6. <b><i>Conclusions:</i></b> CoA specifically affects the smaller twin of growth discordant monochorionic twin pairs. Stent implantation is a feasible bridging therapy to surgery in these low birth weight neonates.

Monochorionic twins with selective fetal growth restriction: insight from placental whole-transcriptome analysis

2020 ◽  
Vol 223 (5) ◽  
pp. 749.e1-749.e16
Author(s):  
Wei Li ◽  
Claire Yik Lok Chung ◽  
Chi Chiu Wang ◽  
Ting Fung Chan ◽  
Maran Bo Wah Leung ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Transcriptome Analysis ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Monochorionic Twins ◽  
Whole Transcriptome Analysis ◽  
Whole Transcriptome
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