Selective intrauterine growth restriction of monochorionic diamniotic twin pregnancies: What is the neonatal prognosis?

Gremillet, Letizia; Netter, A; Tosello, Barthélémy; D’ercole, C.; Bretelle, Florence; Chau, C.

doi:10.1016/j.jogoh.2021.102304

Cited by 4 publications

(3 citation statements)

References 40 publications

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“…However, datasets are available from the sponsor (promotion.interne@ap-hm.fr) on reasonable request and after sign a contract pertaining to the provision of data and/or results. More information on gyneco-obstetrical and perinatal data is available in the article by L. Gremillet et al [33].…”

Section: Data Availability Statementmentioning

confidence: 99%

Neonatal and Long-Term Prognosis of Monochorionic Diamniotic Pregnancies Complicated by Selective Growth Restriction

et al. 2022

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Background: There are few data concerning the neonatal and long-term prognosis of monochorionic biamniotic twin pregnancies (MCBA) complicated by selective intrauterine growth restriction (sIUGR). The aim of the study is to assess the neurological outcomes at two years of age of these newborns and compares these outcomes to those of newborns resulting from intrauterine growth restriction (IUGR) pregnancies. Methods: The study focuses on a cross-sectional prospective cohort of patients treated between 2012 and 2019 in Marseille, France. The primary endpoint is the overall score of the Ages and Stages questionnaires (ASQ) at two years, which assesses the global neurodevelopment. The secondary endpoint is the assessment of neonatal morbi-mortality for both groups (composite endpoint). Results: In total, 251 patients were included in the analysis: 67 in the sIUGR group and 184 in the IUGR group. There was no statistically significant difference in the overall ASQ score at two years but there was the finest motor skills impairment in the IUGR group. The areas most often impaired were communication and fine motor skills. There were no significant differences between the neonatal morbi-mortality of the two groups (adjusted OR = 0.95, p = 0.9). Conclusions: Newborns from MCBA pregnancies with sIUGR appear to have similar overall neurological development to IUGR. Notably, IUGR seems to have the most moderate neurobehavioral disorder (fine motor) as a consequence of impaired antenatal brain development due to placenta insufficiency leading to chronic hypoxia.

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Section: Data Availability Statementmentioning

confidence: 99%

Neonatal and Long-Term Prognosis of Monochorionic Diamniotic Pregnancies Complicated by Selective Growth Restriction

et al. 2022

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“…The incidence of respiratory distress syndrome, intraventricular hemorrhage, seizures, periventricular leukomalacia, sepsis, and necrotizing enterocolitis rose directly with the percentage of weight discordancy ( 17 , 18 ). Most discordancy surveillance begins after the first trimester ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

Investigation of the Association of Abdominal Circumference discordance and Estimated Fetal Weight discordance in twins with birth weight discordance

Barati,

Najafian,

Saadati

et al. 2024

MJIRI

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Background Twin pregnancy is associated with a high risk of mortality and morbidity. It is necessary to estimate the weight difference of the fetuses with a reliable method to prevent possible complications. This study was conducted to compare the association between the Estimated fetal weight (EFW) discord-ance and the Abdominal Circumference (AC) discordance with birth weight in twins. Methods This was a descriptive-analytical and retrospective study. The statistical population was all twin pregnant mothers referred to Imam Khomeini Hospital in Ahvaz from 2017 to 2019. The sample size was determined with a census (540 people). Based on AC , the size of head circumference (HC), femur length (FL), and the Biparietal Diameter (BPD), EFW was calculated. Then the EFW Dis-cordance and AC Discordance were calculated and compared with the birth weight. Data were analyzed using SPSS18. Unpaired, Two-Tailed T-test and Pearson correlation test were used. Results The results showed that the mean discordance of fetal weight in twin pregnancies in the EFW method was 9.25%, in the AC method was 9.89% and finally, at birth, was 10.72%. The correla-tion of the weight difference between the two embryos in the AC method with the time of birth (r = 0.922 and P < 0.001) was higher than in the EFW method with the time of birth (r = 0.69 and P < 0.001) and finally, it was found that in detecting the discordance more than 20% and 25%, AC diagnostic power was good, but EFW was moderate. Conclusion Therefore, to evaluate the weight and weight difference in twin embryos, the AC method has the appropriate accuracy and compatibility. Another major prospective study to evaluate the diagnostic performance of AC and EFW mismatch based on gestational age at scan, incision point, and maternal and placental characteristics to determine true ultrasound diagnostic accuracy in predict-ing growth mismatch in twin pregnancy and optimal post-case management option is needed.

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“…Twin pregnancies can also experience selective fetal growth restriction (sFGR), where one twin is compromised while the other grows normally. This condition puts the affected twins at a higher risk of perinatal mortality and morbidity [1] . Additionally, compared to non-sFGR pregnancies, those with sFGR tend to have earlier deliveries and higher rates of neonatal unit admission [2] .…”

Section: Introductionmentioning

confidence: 99%

Increased fetal fraction is associated with the incidence of birth weight discordance and selective fetal growth restriction：a retrospective cohort study

Hua

Xia

Wang

et al. 2023

Preprint

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Objective To test the hypothesis that the fetal fraction in twin pregnancy would reflect birthweight discrepancy. Design Retrospective cohort study. Setting International Peace Maternity and Child Health Hospital in Shanghai, China Population We included 237 twin pregnancies undergoing cfDNA screening for aneuploidy and delivered at International Peace Maternity and Child Health Hospital in Shanghai, China between January 2018 to December 2021. Exclusion criteria including abnormal NIPT results， fetal demise or structural abnormalities. Methods All women with twin pregnancies were offered a scan to determine chorionicity as well as first-trimester nuchal translucency (NT) at 11 -13 weeks. Dichorionic was confirmed when ultrasound assessment clearly indicates two placentas. The twin peak sign is used to distinguish chorionicity if only one placenta is visualized. Main Outcome Measures Fetal fraction and birth weight of the new borns were collected. Relationships between fetal fraction and birth weight discordance or sFGR were analysed. Results Fetal fraction was positively correlated with the difference of birth weight (β=0.004, 95%CI: 0.001~0.006). Higher fetal fraction was significantly associated with the increased risk of birthweight discordance of 20% (adjusted OR:1.073, 95%CI: 1.009~1.142) and 25% (adjusted OR:1.092, 95%CI: 1.006~1.185) and sIUGR(adjusted OR:1.130, 95%CI: 1.038~1.231). We obtained the optimum cut-off point of fetal fraction ≥ 11.790, ≥ 14.800 and ≥ 14.800 for birthweight discordance of 20% and 25% and sFGR, respectively. Conclusion This study shown that fetal fraction was positively correlated with the difference of birth weight. Fetal fraction could be used as a biomarker in predating birth weight discordance and sFGR, and help to make individualized clinical monitoring plans for twin pregnancies.

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Selective intrauterine growth restriction of monochorionic diamniotic twin pregnancies: What is the neonatal prognosis?

Cited by 4 publications

References 40 publications

Neonatal and Long-Term Prognosis of Monochorionic Diamniotic Pregnancies Complicated by Selective Growth Restriction

Neonatal and Long-Term Prognosis of Monochorionic Diamniotic Pregnancies Complicated by Selective Growth Restriction

Investigation of the Association of Abdominal Circumference discordance and Estimated Fetal Weight discordance in twins with birth weight discordance

Increased fetal fraction is associated with the incidence of birth weight discordance and selective fetal growth restriction：a retrospective cohort study

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