Clinical significance of first trimester crown-rump length disparity in dichorionic twin gestations

Kalish, Robin B.; Gupta, Mala; Perni, Sriram C.; Berman, Seth; Chasen, Stephen T.

doi:10.1016/j.ajog.2004.06.101

Cited by 52 publications

(49 citation statements)

References 14 publications

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“…1 Such discrepancies in first-trimester CRL measurements have been associated with chromosomal abnormalities, anatomic malformations, 2 and discordant birth weights. 3 Whether CRL dissimilarity specifically in chromosomally euploid and structurally normal twins is associated with adverse perinatal outcomes is unknown.…”

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confidence: 99%

Discordance of First-Trimester Crown-Rump Length Is a Predictor of Adverse Outcomes in Structurally Normal Euploid Dichorionic Twins

Fareeduddin

Williams

Solt

et al. 2010

Journal of Ultrasound in Medicine

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Objective. The purpose of this study was to determine the association between discordant crownrump length (CRL) measurements in structurally normal euploid dichorionic twins and adverse pregnancy outcomes. Methods. This retrospective cohort study included women with dichorionic twins who underwent chorionic villus sampling and delivered in our facility from January 2000 to September 2007. Only pregnancies with viable twin fetuses and normal karyotypes were included. The association between CRL discordance, defined as a CRL discrepancy of 9% or greater, and adverse pregnancy outcomes was evaluated. Results. Seventy-eight women met inclusion criteria and included 24 discordant twins (group 1) and 54 concordant twins (group 2). Maternal ages were similar: mean ± SD, 38.2 ± 3.1 years in group 1 versus 39.2 ± 3.9 years in group 2 (P = not significant). The median gestational ages at delivery were 35.6 ± 3.1 weeks in group 1 and 37.3 ± 2.0 weeks in group 2 (P < .01). At least 1 major complication occurred in 19 women (79%) in group 1 and 25 (46%) in group 2 (P = .01). Group 1 had significantly more major complications overall (P = .0008). Preterm premature rupture of membranes occurred in 10 women (42%) in group 1 and 6 (11%) in group 2 (P = .005). Delivery before 37 weeks' gestation occurred in 19 of 24 women (79%) in group 1 and 24 of 54 (44%) in group 2 (P = .006). There was a significant difference for younger gestational age at delivery in the discordant group (P < .01). Conclusions. Our data suggest that there is an increased risk of adverse pregnancy outcomes in chromosomally normal dichorionic twins with first-trimester discordant CRL measurements. These results may be clinically useful for counseling, management, and antenatal surveillance. Key words: crown-rump length; dichorionic; discordance; prenatal diagnosis; twin. Whether CRL dissimilarity specifically in chromosomally euploid and structurally normal twins is associated with adverse perinatal outcomes is unknown. Tai and Grobman 4 reported an increased incidence of intrauterine growth restriction in at least one of the twin pair with first-trimester discordance above the 85th percentile and significantly increased composite perinatal morbidity. However, the fetal karyotype and stratification of outcome Received March 8, 2010, from the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (R.F., J.W., I.S., M.J.K., S.R.), and Division of Biostatistics (J.M.M.), Cedars-Sinai

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confidence: 99%

Discordance of First-Trimester Crown-Rump Length Is a Predictor of Adverse Outcomes in Structurally Normal Euploid Dichorionic Twins

Fareeduddin

Williams

Solt

et al. 2010

Journal of Ultrasound in Medicine

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“…0.336 + 8.10, r 2 = 0.07, p = 0.29; unpublished data). In addition, first-trimester CRL disparity in dichorionic twin pregnancies has been reported to be associated with an increased risk of fetal structural and chromosomal anomalies [8,18] . Fetal reduction following ART has also been suggested to affect pregnancy outcome and fetal growth [13] .…”

Section: Discussionmentioning

confidence: 99%

The Influence of Assisted Reproductive Technology on Growth Discordance in Dichorionic Twin Pregnancies

Suzuki

Murata²

2007

Fetal Diagn Ther

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Objective: We examined the relation between first-trimester crown-rump length (CRL) discordance and birth weight discordance in dichorionic twin pregnancies conceived by assisted reproductive technology (ART). Methods: We examined 101 nulliparous dichorionic twin pregnancies producing male-male or female-female infants conceived spontaneously (n = 38) or following in vitro fertilization and embryo transfer (n = 63). Results: There were no significant differences in CRL disparity or birth weight discordance between spontaneous and ART-conceived dichorionic twin pregnancies. There was a positive correlation between CRL disparity and birth weight discordance in ART-conceived twin pregnancies (r² = 0.22, p = 0.02), while there was no such correlation in spontaneous pregnancies (r² = 0.02, p = 0.40). Conclusion: In ART-conceived dichorionic twin pregnancies, CRL disparity may be associated with birth weight discordance.

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“…Traditionally, growth patterns of both fetuses within a twin gestation have been thought to be uniform until the later half of pregnancy when growth differences may emerge. However, some studies have suggested that divergent growth patterns in early pregnancy may be associated with unfavorable pregnancy outcomes, including fetal death and congenital anomalies [1,2,19,21,22].…”

Section: Introductionmentioning

confidence: 98%

First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies

Maric

Singh

Duncan

et al. 2014

Journal of Perinatal Medicine

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Clinical significance of first trimester crown-rump length disparity in dichorionic twin gestations

Cited by 52 publications

References 14 publications

Discordance of First-Trimester Crown-Rump Length Is a Predictor of Adverse Outcomes in Structurally Normal Euploid Dichorionic Twins

Discordance of First-Trimester Crown-Rump Length Is a Predictor of Adverse Outcomes in Structurally Normal Euploid Dichorionic Twins

The Influence of Assisted Reproductive Technology on Growth Discordance in Dichorionic Twin Pregnancies

First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies

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