“…We studied severe abnormal umbilical artery Doppler (RI) values in TP for two reasons. First, even if only a few studies have assessed the role of severe abnormal artery umbilical waveforms in TP, all of their authors agree that this feature is associated with a 50% positive predictive value of morbidity and mortality after midpregnancy (13), (14). Second, Sato (23), (24) and Feldman (25) have underlined the importance of umbilical cord artery analysis in understanding the pathophysiology of IUGR, notably in monochorionic twin pregnancies.…”
Section: Discussionmentioning
confidence: 99%
“…In addition, the presence of an anomalous triplet not only compromises the survival of that fetus, but equally the survival of normal cotriplets (12). Lastly, a few studies on a small number of pregnancies have underlined the adverse prognostic influence of pathological umbilical artery Doppler indices in TP (13), (14).…”
Early prenatal diagnosis of chorionicity is of major importance in triplet pregnancy. Experienced sonographers must quickly evaluate any uncertain diagnosis. In cases of unknown chorionicity, other ultrasonographic criteria can highlight high-risk triplet pregnancy, but at a later stage.
“…We studied severe abnormal umbilical artery Doppler (RI) values in TP for two reasons. First, even if only a few studies have assessed the role of severe abnormal artery umbilical waveforms in TP, all of their authors agree that this feature is associated with a 50% positive predictive value of morbidity and mortality after midpregnancy (13), (14). Second, Sato (23), (24) and Feldman (25) have underlined the importance of umbilical cord artery analysis in understanding the pathophysiology of IUGR, notably in monochorionic twin pregnancies.…”
Section: Discussionmentioning
confidence: 99%
“…In addition, the presence of an anomalous triplet not only compromises the survival of that fetus, but equally the survival of normal cotriplets (12). Lastly, a few studies on a small number of pregnancies have underlined the adverse prognostic influence of pathological umbilical artery Doppler indices in TP (13), (14).…”
Early prenatal diagnosis of chorionicity is of major importance in triplet pregnancy. Experienced sonographers must quickly evaluate any uncertain diagnosis. In cases of unknown chorionicity, other ultrasonographic criteria can highlight high-risk triplet pregnancy, but at a later stage.
The objective of this longitudinal study was to evaluate alterations in fetal vascular resistance of fetal peripheral arteries with advancing gestation in singleton appropriate-for-gestational-age (S-AGA), twin appropriate-for-gestational-age (Tw-AGA) and triplet appropriate-for-gestational-age (Tri-AGA) infants. Colour Doppler flow imaging and pulsed Doppler ultrasonographic examinations were performed on 35 S-AGA, 52 Tw-AGA and 12 Tri-AGA fetuses. The pulsatility index for middle cerebral artery (MCAPI), umbilical artery (UAPI), descending aorta (DAPI), splenic artery (SAPI), renal artery (RAPI) and femoral artery (FAPI) was measured as vascular resistance every 2 weeks after 15 weeks of menstrual age until delivery. Optimal models and normal ranges for pulsatility index for each artery in each group were generated. The alterations in various fetal regional arterial pulsatility indices with advancing gestational age showed no significant differences in S-AGA, Tw-AGA and Tri-AGA infants, respectively. These results suggest that there is no significant difference for regional arterial vascular resistance in AGA fetuses among singleton, twin, and triplet pregnancies, whereas there was a slight difference in fetal growth pattern among singleton, twin, and triplet pregnancies described in our previous investigation.
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