Natural evolution and risk factors for adverse outcome in selective intrauterine growth restriction under expectant management: A retrospective observational study

Abstract

Selective intrauterine growth restriction (sIUGR) accounts for approximately 10%-15% of monochorionic diamniotic (MCDA) twins and is one of the most severe complications. 1 Selective IUGR is associated with increased perinatal mortality rate, poor neurological outcome, and higher incidence of endocrine and metabolic diseases, as well as cardiovascular dysfunction in adulthood. 2 The pathogeneses of sIUGR rely not only on the presence of gross placental structure factors, such as abnormal placental sharing and aberrant cord insertion, but also on the magnitude and direction of blood-flow interchange through the placental anastomoses. 3 The umbilical artery (UA) Doppler flow pattern of the smaller twin has been used for classifying