First trimester ultrasonographic parameters in prediction of the course and outcome of monochorionic twin pregnancies

Abstract

The aim of the study was to evaluate the association and the potential predictive value of first trimester ultrasonographic parameters on the course and outcome of monochorionic diamniotic twin pregnancies. Materials and methods:A prospective cohort study was undertaken of 39 healthy women with consecutive monochorionic diamniotic twin pregnancies. During first-trimester screening, crown-rump length (CRL) and nuchal translucency (NT) were measured. The intertwin discordance in CRL and NT was determined. As pregnancy outcomes we assessed twins' live-born rates, Apgar scores, birth weight, pregnancy complications, and gestational week of delivery.Results: None of the assessed pregnancy outcomes significantly correlated with standard CRL discordance ≥10%. The newly established cut-off was 3.75 mm for CRL and 1.3 mm for NT. Monochorionic diamniotic twins were delivered in a later gestational week and had better chance of survival if CRL intertwin difference was <3.75 mm. Apgar scores significantly negatively correlated only with NT of corresponding twins. When intertwin NT difference was ≥1.3 mm, twins had lower birth weight and pregnancy complications were more frequent. Regression models show that intertwin CRL difference <3.75 mm is a significant predictor of live-born monochorionic diamniotic twins. Conclusion:CRL and NT in monochorionic diamniotic twin pregnancies could indicate pregnancy complications and outcomes.

Twin pregnancies concieved by assisted reproduction - early prediction of preterm birth

“…Both early the first and second trimester sonographic examinations are investigated in recent studies for predicting adverse perinatal outcomes 16 . It is postulated that fetuses suffering from reduced oxygenation and/or nutrient limitation caused by progressed pregnancy complications during early pregnancy tend to be smaller when their biometrical measurements are evaluated 17,18 . Several studies have examined the relationship between the parameters obtained during ultrasonographic surveillance of twins with the course, delivery time and type as well as the outcome of both dichorionic and monochorionic twin pregnancies 5,19 .…”

“…Several studies have examined the relationship between the parameters obtained during ultrasonographic surveillance of twins with the course, delivery time and type as well as the outcome of both dichorionic and monochorionic twin pregnancies 5,19 . According to literature data significant correlations of parameters measured and determined during the ultrasound screening such as intertwin differences in CRL and NT, chorionicity, amniotic fluid quantity, AC of both fetuses in the second trimester with the pregnancy outcome and numerous gestational complications are commonly found 15,18 . According to some investigations abnormal measurements of CRL in the first trimester were found to be associated with early fetal loss 10,20 .…”