Prediction of birth weight discordance from fetal weight estimations at 21–24 weeks' scans in monochorionic and dichorionic twins

Abstract

Concordant EFWs at 21-24 weeks exclude discordant birth weight in monochorionic twins whereas discordant EFWs are poor predictors of birth weight discordance especially in dichorionic twins irrespective when the twins were born.

Prediction of Monochorionic Diamniotic Twin Pregnancy Outcomes Based on Early Second Trimester Ultrasound

“…Conversely, other studies have found that secondtrimester ultrasound discordance in twins has poor predictive value for adverse perinatal outcomes, irrespective of chorionicity [1,[18][19][20]. Although in some investigations, second-trimester EFW discordance correlated with birth-weight discordance ≥20-25%, the predictive accuracy was low, thus preventing its wide practical clinical use [7,8]. Once malformations, chromosomal abnormalities, and TTTS were excluded, second-trimester ultrasound discordance was not significantly correlated with subsequent adverse outcomes [1,7,8].…”

“…Although in some investigations, second-trimester EFW discordance correlated with birth-weight discordance ≥20-25%, the predictive accuracy was low, thus preventing its wide practical clinical use [7,8]. Once malformations, chromosomal abnormalities, and TTTS were excluded, second-trimester ultrasound discordance was not significantly correlated with subsequent adverse outcomes [1,7,8]. Moreover, in some studies, even after adjusting for monochorionicity, the predictive value of using either second-trimester EFW or AC discordance did not improve [1,19].…”

“…Some studies indicate that a single biometric assessment of twins at 16 weeks detected 48% of later adverse outcomes. AC and EFW at 16 GW have been established as the most important predictors of adverse fetal outcomes as well as discordant twin growth [7,12,13].…”

“…On the other hand, the literature suggests that both disproportionate and proportionate fetal growth restriction may start in the second trimester, which may lead to poor perinatal outcomes [7]. Antenatal measurement of fetal abdominal circumference has proven to be the most sensitive ultrasound index for the detection of disturbances in fetal growth.…”

Placental T2* estimated by magnetic resonance imaging and fetal weight estimated by ultrasound in the prediction of birthweight differences in dichorionic twin pairs

“…These methods have been extensively studied throughout the last decades. The majority of publications have reached the conclusion of poor sensitivity in predicting intertwin BW discordance [5,6,[9][10][11][12][13], however the performance is better when performed near delivery [7,8,[13][14][15]. Recently, Hehir et al [13] investigated the performance of ultrasound EFW in predicting intertwin BW discordance at different gestational ages.…”