Nuchal translucency thickness and crown rump length discordance for the prediction of outcome in monochorionic diamniotic pregnancies

Fratelli, N.; Prefumo, Federico; Fichera, A.; Valcamonico, Adriana; Marella, D.; Frusca, T.

doi:10.1016/j.earlhumdev.2010.09.375

Cited by 39 publications

(52 citation statements)

References 22 publications

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“…This difficulty is common to all studies that follow twin fetuses from the first to the second trimester, which is the usual period when complications manifest themselves. Moreover, our study, which compares well numerically to others on the same subject [1,2,4,9,15], although prospectively assessed, is not extensive, and our findings must be further confirmed in a larger series. More studies are needed before evaluating the clinical application of the results from our preliminary study.…”

Section: Couples Of Twinssupporting

confidence: 76%

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Umbilical vein volume flow in monochorionic twin pairs at 11–14 weeks

Zoppi¹,

Iuculano²,

Monni³

2014

Journal of Perinatal Medicine

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We investigated the umbilical vein volume flow (UVVF) at 11-14 weeks in monochorionic-diamniotic (MCDA) twins, focusing on the occurrence of complications. We considered 87 MCDA pregnancies. We used "E-flow" to detect the umbilical vein and measured the mean velocities and diameters of veins, also calculating the UVVF. Pregnancies were divided into four groups: a (twin-to-twin transfusion, TTTS); b (selective intrauterine growth restriction, sIUGR); c (discordance of fluid, DF); and d (with "normal" outcome). The main outcome of the study was the assessment of the difference of UVVF between twin 1 and twin 2 (larger and smaller twin). In eight of eight pairs of group a and seven of seven pairs of group b, the UVVF of fetuses 1 were significantly different than fetuses 2 (P<0.05). The UVVFs of fetuses 2 of group a were significantly lower in respect to the UVVFs of fetuses 2 of group d (P<0.05). We provide evidence of an important difference in UVVF in pairs that successively developed TTTS or sIUGR. The smaller fetuses of group a (TTTS) showed a lower venous return than fetuses 2 of group d (normal). First-trimester UVVF is lower in fetuses with a smaller crown-rump length in twin pairs at risk of TTTS or IUGR.

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Section: Couples Of Twinssupporting

confidence: 76%

“…It could prove useful when monitoring such pregnancies, together with other signs that have already been more widely studied, although with conflicting conclusions, such as CRL, NT, and ductus venosus [1,2,4,8,15]. …”

Section: Couples Of Twinsmentioning

confidence: 99%

Umbilical vein volume flow in monochorionic twin pairs at 11–14 weeks

Zoppi¹,

Iuculano²,

Monni³

2014

Journal of Perinatal Medicine

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“…An intertwin CRL disparity of more than 10% was identified as an extremely weak predictive marker of intrauterine death, whereas it was revealed to be poorly associated with preterm birth, as well as birth weight discrepancy, in dichorionic twin gestations [49]. Finally, Fratelli et al [47] failed to substantiate a correlation between the difference in nuchal translucency (NT) and CRL and development of twin-to-twin transfusion syndrome in monochorionic twin pregnancies.…”

Section: Crown-rump Length Discordance and Perinatal Outcomementioning

confidence: 99%

“…A series of previous studies have indicated a correlation between intertwin CRL discrepancy in first trimester and poor perinatal outcome (intrauterine death, perinatal mortality, preterm birth) [30,[35][36][37][38][39][40][41][42][43][44][45][46][47][48] (Table 2). Nevertheless, most of them failed to verify the predictive value of CRL discrepancy for adverse outcome.…”

Section: Crown-rump Length Discordance and Perinatal Outcomementioning

confidence: 99%

Intertwin estimated fetal weight or crown rump length discordance and adverse perinatal outcome

Kaponis

Thanatsis

Papadopoulos

et al. 2015

Journal of Perinatal Medicine

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Aim: In the current review study, we present recent data regarding the importance of intertwin estimated fetal weight (EFW) and crown rump length (CRL) discordance for the prediction of adverse perinatal outcome both in monochorionic and in dichorionic diamniotic gestations. Results: Twins with significant weight disparity are associated with higher rates of perinatal morbidity and mortality, regardless of gestational age at delivery. However, there is no agreement regarding as to the cut off value above which the perinatal outcome is unfavorably affected and the threshold range from 10 to 30%. On the other hand, CRL discrepancy has proved to be a weak predictor of adverse outcomes, such as fetal or neonatal death in fetuses without chromosomal and structural abnormalities. In clinical practice, decisions about obstetric surveillance of discordant twin gestations, frequency of fetal sonographic monitoring and time of delivery are usually based on amniotic fluid volume and Doppler assessments on a weekly basis. Conclusion: Significant EFW discordance leads to adverse perinatal outcome, although the cut-off value has not yet been estimated. CRL discrepancy is not correlated well with adverse perinatal outcome. However, increased monitoring of women with EFW and CRL discrepancy is suggested.

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“…Discordant NT measurements in MC twins have been associated with an increased risk of fetal aneuploidy, discordance growth without TTTS, and intrauterine fetal demise. [23][24][25][26][27] Doppler blood flow studies of the DV have been considered surrogate of cardiac function. As such it has been suggested that the hemodynamic imbalance and the cardiac dysfunction of TTTS may be indirectly manifested early in gestation by abnormal blood flow in the DV.…”

Section: Screeningmentioning

confidence: 99%

Diagnosis and Management of Twin-Twin Transfusion Syndrome

Johnson

2015

Clinical Obstetrics &Amp; Gynecology

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Twin-twin transfusion syndrome (TTTS) affects 10% to 15% of monochorionic pregnancies. In the absences of timely diagnosis and intervention perinatal loss or long term developmental delay can be expected in over 90% of cases. Establishing chorionicity in the first trimester followed by serial ultrasounds beginning at 16 weeks of gestation and intervention with placental laser ablation before the development of advance disease overall survival rates can be expected in 70% to 80% of cases.

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Nuchal translucency thickness and crown rump length discordance for the prediction of outcome in monochorionic diamniotic pregnancies

Cited by 39 publications

References 22 publications

Umbilical vein volume flow in monochorionic twin pairs at 11–14 weeks

Umbilical vein volume flow in monochorionic twin pairs at 11–14 weeks

Intertwin estimated fetal weight or crown rump length discordance and adverse perinatal outcome

Diagnosis and Management of Twin-Twin Transfusion Syndrome

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