Journal articles: 'Fetal weight discordance'

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Kostyukov, K. V., K. A. Gladkova, and O. V. Ionov. "Assessing an impact on perinatal outcome in monochorionic and dichorionic twin pregnancy complicated with discordant fetal growth." Obstetrics, Gynecology and Reproduction 15, no. 1 (March 6, 2021): 51–60. http://dx.doi.org/10.17749/2313-7347/ob.gyn.rep.2021.172.

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Introduction. Multifetal pregnancy is associated with an increased risk of perinatal morbidity and mortality. Type of placentation and discordant fetal growth may be risk factors of adverse pregnancy outcomes.Aim: to compare an impact of dichorionic and monochorionic twin pregnancies with symmetric and discordant fetal growth on perinatal outcomes, as well as morbidity and mortality.Materials and Methods. There was conducted a retrospective study of 485 pregnant women and paired 959 newborns. Depending on the type of chorionicity, subjects were stratified into two study groups being further subdivided into based on describing fetal weight discordance. The antenatal period and the neonatal outcome of newborns in groups and subgroups were compared.Results. We analyzed 308 dichorionic and 177 monochorionic twin pregnancies. It was found that neonate discordant growth was observed in 5.4 % and 13.4 % (p < 0.001), respectively. The incidence of assisted reproductive technologies was higher in dichorionic than in monochorionic twins comprising 66.5 and 40.7 % (р < 0.001). Antenatal mortality in monochorionic vs. dichorionic twins was by 8-fold higher. The preterm birth rate in monochorionic vs. dichorionic twins was 74.6 and 62.7% (p = 0.009), respectively. Neonate body weight in monochorionic vs. dichorionic twins was lowered comprising 1991 and 2430 gr. (р < 0.001), respectively. Low Apgar scores were more common for monochorionic twins with discordant body weight. The rate of early neonatal mortality in monochorionic vs. dichorionic twins was 4.4 % vs. 1.5 % (p = 0.009), whereas in dichorionic vs. monochorionic twins with weight discordance it was up to 5.8 and 10.5% (р < 0.001), respectively.Conclusion. Monochorionic twin pregnancy complicated with growth discordance is associated with a higher risk of adverse antenatal period as well as neonatal morbidity and mortality compared to symmetric DCDA twins. Chorionicity and growth discordancy represent important predictors for outcome of twin pregnancy.

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Zipori, Yaniv, Karen Reidy, T. Gilchrist, Lex W. Doyle, and Mark P. Umstad. "The Outcome of Monochorionic Diamniotic Twins Discordant at 11 to 13+6 Weeks’ Gestation." Twin Research and Human Genetics 19, no. 6 (October 21, 2016): 692–96. http://dx.doi.org/10.1017/thg.2016.81.

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Background: Monochorionic diamniotic (MCDA) twin pregnancies are associated with adverse perinatal outcome. Intertwin discordances at the time of nuchal translucency (NT) screening may have a value in the prediction of fetal loss or twin-to-twin transfusion syndrome. We aimed to determine the ability of intertwin NT and crown rump length (CRL) discordances among MCDA twins to predict adverse outcomes. Material and Methods: All MCDA twins with a documented routine ultrasound at 11 to 13+6 weeks’ gestation, and known pregnancy outcome between August 2003 and August 2012 were included. Receiver operating characteristic curves were used to determine the ideal NT and CRL discordances cut-off points that maximized the ability to predict adverse outcome, which was defined as any of: death of one or both twins, twin-to-twin transfusion syndrome, or estimated fetal weight or birth weight discordances ≥25%. Results: Of the 89 cases, 20 (22.5%) had at least one adverse outcome. NT discordance was more discriminatory of adverse outcome than was CRL discordance. The optimal values for predicting any adverse outcomes for NT were >23.7% and for CRL >3.5%. The positive predictive values for NT (52.4%) and CRL (29.8%) screening were relatively low; however, the lack of either NT or CRL discordances was more reassuring, with negative predictive values of 86.8% and 86.4%, respectively. Conclusions: NT discordance is more predictive for adverse fetal outcome in MCDA twins than CRL discordance. Neither NT nor CRL discordance are likely to modify the intensive monitoring required for these very high-risk pregnancies.

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Ahiron, R., and I. Blickstein. "Persistent Discordant Twin Growth Following IVF-ET." Acta geneticae medicae et gemellologiae: twin research 42, no. 1 (1993): 41–44. http://dx.doi.org/10.1017/s051528360004227x.

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AbstractWe observed persistent first trimester growth disparity in a twin pregnancy following IVF-ET. The crown-rump length of the two fetuses was substantially different at 7 and 11 weeks and from the 20th week discordant growth was observed by intertwin differences in abdominal circumferences and estimated fetal weights. Birth weight discordance was 26.6% (1600/2180). This is apparently the first documentation of first trimester growth discordance persisting throughout pregnancy.

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D'Antonio, Francesco, Asma Khalil, Maddalena Morlando, and Basky Thilaganathan. "Accuracy of Predicting Fetal Loss in Twin Pregnancies Using Gestational Age-Dependent Weight Discordance Cut-Offs: Analysis of the STORK Multiple Pregnancy Cohort." Fetal Diagnosis and Therapy 38, no. 1 (2015): 22–28. http://dx.doi.org/10.1159/000369326.

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Objectives: A third-trimester fetal weight discordance of 25% has been proposed as an independent predictor of fetal loss in twin pregnancies. As fetal weight gain at this stage of pregnancy increases exponentially, it is not entirely certain whether a single cut-off for inter-twin weight discordance is appropriate. The aim of this study was to investigate whether a single weight discordance cut-off can be used or whether different cut-offs should be adopted according to the gestational age at assessment. Methods: This was a retrospective study of all twin pregnancies of known chorionicity from a large regional cohort over a 10-year period. Receiver operating characteristic curve and logistic regression analyses were used to explore the relation between estimated fetal weight (EFW) discordance detected within 4 weeks from the occurrence of the outcome and single fetal loss at different gestational age windows. Results: 957 twin pregnancies (173 monochorionic and 784 dichorionic) were included in the analysis. EFW discordance was independently associated with the occurrence of single fetal loss in twin pregnancies in each gestational age window. Ultrasound EFW discordance had an area under the curve of 0.77 (95% CI: 0.67-0.87) for the prediction of single fetal loss in the third trimester of pregnancy, with an optimal cut-off of around 25% (23.2%). The optimal cut-offs of EFW discordance for the prediction of single fetal loss were different in each gestational age window. Conclusion: The accuracy of EFW discordance in predicting single fetal loss in twin pregnancies varies during the third trimester of pregnancy. The degree of fetal weight discordance associated with fetal loss decreases during the third trimester, suggesting that the weight discordance threshold for intervention should vary according to gestational age.

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Sklar, Cameron, Maryna Yaskina, Sue Ross, and Kentia Naud. "Accuracy of Prenatal Ultrasound in Detecting Growth Abnormalities in Triplets: A Retrospective Cohort Study." Twin Research and Human Genetics 20, no. 1 (January 20, 2017): 84–89. http://dx.doi.org/10.1017/thg.2016.92.

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Significant management decisions in triplet pregnancies are made based mainly on ultrasound measurements of fetal growth, although there is a paucity of data examining the accuracy of fetal weight measurements in these gestations. To evaluate accuracy of prenatal ultrasound to diagnose growth abnormalities (intrauterine growth restriction, severe growth discordance) in triplet pregnancies, a retrospective cohort study of 78 triplet pregnancies (234 fetuses) delivered at a single tertiary hospital from January 2004 to May 2015 was performed. Growth percentiles from the last ultrasound were derived from estimated fetal weight using Hadlock's formula for each triplet. Growth discordance was calculated for each triplet set using the formula {(estimated fetal weight largest triplet - estimated fetal weight smallest)/estimated fetal weight largest}. These estimations were compared to birth weights. Sensitivity of ultrasound to predict ≥1 growth restricted fetus in a triplet set was 55.6% [95% CI 35.3, 74.5]; specificity was 100% [95% CI 93.0, 100]; positive predictive value (PPV) 100% [95% CI 74.7, 100]; negative predictive value (NPV) 81.0% [95% CI 73.2, 85.7%]. Sensitivity of ultrasound to detect fetal growth discordance >25% in a triplet set was 80.0% [95% CI 44.4, 97.5], specificity 94.1% [95% CI 85.6, 98.4]; PPV 66.7% [95% CI 42.4, 84.5]; NPV 97.0% [95% CI 90.2, 99.1]. Prenatal ultrasound currently remains the most reliable tool to screen for growth anomalies in triplet pregnancies; however, it appears to have less than ideal sensitivity, missing a number of cases of intra-uterine growth restriction and significant growth discordance.

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Sa, Renato A. Moreira de, Salomon J. Laurent, Yuichiro Takahashi, Masami Yamamoto, and Yves Ville. "The impact of laser therapy on fetal growth discordance in twin-to-twin transfusion syndrome." Revista Brasileira de Saúde Materno Infantil 5, no. 3 (September 2005): 313–17. http://dx.doi.org/10.1590/s1519-38292005000300007.

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OBJECTIVES: to evaluate the impact of laser therapy on inter-twin discordance in twin-to-twin transfusion syndrome (TTTS). METHODS: biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL) and estimated fetal weight were prospectively collected during a five-year period (1999 to 2004). The inter-twin discordance was expressed as a percentage of the largest twin's measurements. The measurements were made the day before laser, twice following laser and after delivery. The mean values of discordance in measurements and in fetal weight were calculated. ANOVA was used to compare mean values. RESULTS: the mean (SD) discordance for BPD, HC, AC, FL and estimated fetal weight the day before laser were 8.53% (5.28), 8.75% (2.76), 16.19% (4.85), 12.92% (5.13) and 28.50% (6.46) respectively. At the at 2nd ultrasound assessment after surgery were 4.37% (3.55), 3.73% (2.71), 8.90% (4.42), 6.61% (4.99) and 19.11% (8.01) respectively; and at birth the weight discordance was 18.55% (8.74). There was a significant decrease in discordance for HC and AC for each ultrasound assessment. CONCLUSIONS: there was a decrease in fetal growth discordance following laser therapy in TTTS. These changes might be related to re-adaptation of blood flow following laser therapy.

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Machado, Rita C. A., Maria L. Brizot, Adolfo W. Liao, Fábio R. Cabar, and Marcelo Zugaib. "Prenatal Sonographic Prediction of Twin Growth Discordance." Twin Research and Human Genetics 10, no. 1 (February 1, 2007): 198–201. http://dx.doi.org/10.1375/twin.10.1.198.

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AbstractOur aim was to evaluate the ability of prenatal ultrasound scans to predict fetal growth discordance, and to examine the correlation between fetal weight estimated by ultrasound with actual birthweight in twin pregnancies. The study consisted of 221 twin pregnancies with ultrasound fetal weight estimates based on Hadlock's 4 parameter formula. Prediction of intertwin birthweight discordance was examined at 4 different intervals between ultrasound examination and delivery (0–7 days, n = 96; 8–14 days, n = 66; 15–21 days, n = 58; 22–28 days, n = 59 pregnancies), with a total of 279 ultrasound examinations. Birthweight discordance was considered as a difference of 20% or greater. The correlation between fetal weight estimated between 0 and 7 days and actual birthweight was calculated by intraclass correlation coefficient. The predictive values for intertwin discordance of 20% or more in the 0 to 7 days group were: sensitivity = 93.6%, specificity = 79.4%, positive predictive value = 89.2%, negative predictive value = 87.1% and accuracy = 88.6%. In the groups with scans carried out between 8 and 14 days, 15 and 21 days, and 22 and 28 days, the sensitivity and accuracy values were 95.8% and 84.9%, 95.6% and 84.5%, 90.9% and 84.8%, respectively. Fetal growth discordance in twins can be accurately predicted by ultrasound examination performed up to 28 days before birth. There is a good correlation between fetal weight estimated between 0 and 7 days and actual birthweight.

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Tepla, I. "COMPARATIVE ANALYSIS OF THE NEONATE BIRTH WEIGHT IN DIFFERENT TYPES OF TIN PREGNANCY." Medical Science of Ukraine (MSU) 17, no. 1 (March 30, 2021): 35–46. http://dx.doi.org/10.32345/2664-4738.1.2021.05.

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The relevance of the study lies in the significant increase in multiple pregnancies connected with the higher risk of perinatal complications, the controversy over the effects of chorionicity and sex of the babies on their birth weight, the need for timely diagnosis of fetal growth restriction, and associated morbidity. The objective of this study was to compare fetal weights at the birth of different variants of twins depending on chorionicity, gestational age, and sex. Materials and methods. During 2016-2020, 440 pairs of twins were examined: 375 dichorionic diamniotic and 65 monochorionic diamniotic (38 – boys, 27 – girls). Among dichorionic couples there were 186 (49.6%) opposite-sex, 98 (26.1%) same-sex males and 91 (24.3%) same-sex females. Fetal weight was measured at birth, and its relationship to chorionicity, fetal sex, a combination of same-sex or opposite-sex co-twins, and gestational age was assessed. Results. The average weight of 750 fetuses from dichorionic pairs (2570.0 ± 506.43 g) significantly exceeded the weight of 130 fetuses from monochorionic pairs (2333.4 ± 567.24 g, p < 0.0001). The same-sex male (2603.8 ± 532.29 g) and opposite-sex dichorionic diamniotic (2595.6 ± 490.17 g). twins’ masses significantly surpassed the mass of all other twins (p <0.05). In the group of dichorionic twins, the weight of boys exceeded the weight of girls (2638.1 ± 525.96 g vs. 2499.4 ± 475.84 g, p = 0.0002). This pattern was observed both inside the opposite-sex pairs (2674.2 ± 518.17 g vs. 2517.1 ± 448.24 g, p = 0.0019), and same-sex couples of boys compared to same-sex couples of girls (2603.8 ± 532.29 g and 2481.4 ± 503.08 g, respectively, p = 0.0224). No significant difference in the weight of girls of opposite-sex twins compared to same-sex couples was seen. In monochorionic pairs, the weight of male and female fetuses did not differ significantly. Birth weight discordance was found in all types of twins, the highest percentage of discordance was registered in monochorionic boys – 23.7%, second place in frequency took male dichorionic twins – 20.4%. Among the 30 discordant dichorionic opposite-sex twins in 19 (63.3%) cases, the male fetus was heavier. There was no significant difference in fetal weight when women were fertilized naturally and using assisted reproductive technologies. The average weight of children born by surrogate mothers exceeded the weight of children born by non-surrogate mothers (p = 0.0466). In the first pregnancy, children were born with a lower body weight compared to children born as a result of repeated pregnancies and in women who had a history of childbirth. Conclusion. The average weight of the fetuses of dichorionic twins was higher than the weight of the neonates f monochorionic pairs. The prevalence of the weight of boys over the weight of girls from dichorionic pairs and the absence of sex difference in fetal weight in monochorionic twins indicates the possibility of different functional activity of the placenta in fetuses of different sexes. Small for gestational age newborns were most often found in the group of female monochorionic twins and opposite-sex dichorionic pairs. Discordance of fetal mass was most common in monochorionic same-sex male twins. In discordant opposite-sex couples, the male fetus more often was heavier. There was no significant difference in newborn weight when women were fertilized naturally and with the use of assisted reproductive technologies. The average weight of surrogate-born children exceeded the weight of children born by non-surrogate mothers. In the first pregnancy, children were born with a lower body weight compared to children of multiparous and multigravida women.

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GRATACÓS, EDUARD, ELISENDA EIXARCH, and FATIMA CRISPI. "DIAGNOSIS AND MANAGEMENT OF SELECTIVE FETAL GROWTH RESTRICTION IN MONOCHORIONIC TWINS." Fetal and Maternal Medicine Review 20, no. 4 (October 12, 2009): 269–81. http://dx.doi.org/10.1017/s0965539509990106.

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Selective fetal growth restriction (sFGR) has been reported to occur in about 10–15% of monochorionic (MC) twins. The diagnosis of sFGR has been based on variable criteria including estimated fetal weight (EFW), abdominal circumference and/or the degree of fetal weight discordance. Recent studies tend to use a simple definition which includes the presence of an EFW less than the 10th percentile in the smaller twin. Some would argue that the intertwin fetal weight discordance should be included in the definition. Indeed this factor plays a major role in the complications presented by these cases. While the majority of cases with one fetus below the 10th percentile usually will also present with a large intertwin EFW discordance, the contrary is not always true. Thus, it is possible to find MC twins with remarkable intertwin EFW discordance but the EFW of both fetuses are still within normal ranges. Although it appears to be common sense that a large intertwin discrepancy might represent a higher risk for some of the complications described later in this review, there is no consistent evidence to support this notion. Therefore, due to its simplicity, a definition based on an EFW below 10th percentile in one twin is probably the most useful for clinical and research purposes.

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Chang, Yao-Lung, Shuenn-Dyh Chang, An-Shine Chao, Peter C. C. Hsieh, Chao-Nin Wang, and Tzu-Hao Wang. "Placenta Share Discordance and Umbilical Artery Doppler Change After Antenatal Betamethasone Administration in Monochorionic Twins With Selective Intrauterine Growth Restriction: Is There a Link?" Twin Research and Human Genetics 15, no. 5 (July 3, 2012): 680–84. http://dx.doi.org/10.1017/thg.2012.39.

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This study was designed to evaluate the degree of placenta share discordance in relation to the betamethasone-induced return of positive end-diastolic flow in monochorionic twin pregnancies with selective intrauterine growth restriction (sIUGR) and abnormal umbilical artery Doppler. Monochorionic twins with sIUGR was defined as one twin having an estimated fetal weight below the 10th percentile combined with an estimated fetal weight discordance >25%. The umbilical artery Doppler directly prior to (D0) and 24 hours (D1) and 48 hours (D2) after the first dose of betamethasone administration was recorded. The estimated individual placental weight in monochorionic twins was obtained by cutting the placenta along the vascular equator into two territories; the placenta share discordance was calculated as [(estimated individual placental weight of appropriated for gestational age twin- estimated individual placental weight of growth restricted twin)/estimated individual placental weight of appropriated for gestational age twin] × 100%. Six (23.1%) of the 26 included cases achieved betamethasone-induced return of positive umbilical artery end-diastolic flow. The difference of placenta share discordance and birth weight discordance were not significantly different between twins with and without betamethasone-induced return of positive umbilical artery end-diastolic flow. Thus, according to our study results, it was proposed that although the placenta share discordance correlated with the abnormal umbilical artery Doppler in the IUGR fetus in monochorionic twin, the betamethasone-induced return of positive umbilical artery end-diastolic flow, however, did not reveal the similar relationship with the severity of placenta share discordance.

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Fox, Nathan S., Daniel H. Saltzman, Rachel Schwartz, Ashley S. Roman, Chad K. Klauser, and Andrei Rebarber. "Second-Trimester Estimated Fetal Weight and Discordance in Twin Pregnancies." Journal of Ultrasound in Medicine 30, no. 8 (August 2011): 1095–101. http://dx.doi.org/10.7863/jum.2011.30.8.1095.

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Giorgione, Veronica, Amar Bhide, Rohan Bhate, Keith Reed, and Asma Khalil. "Are Twin Pregnancies Complicated by Weight Discordance or Fetal Growth Restriction at Higher Risk of Preeclampsia?" Journal of Clinical Medicine 9, no. 10 (October 13, 2020): 3276. http://dx.doi.org/10.3390/jcm9103276.

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Studies have reported controversial findings on the association between fetal growth restriction (FGR) or intertwin weight discordance and the risk of hypertensive disorders of pregnancy (HDP) in twin pregnancies. The aim of this study was to investigate the association between twin growth disorders and HDP. Twin pregnancies resulting in two live births at St George’s Hospital between 2000 and 2019 were included. FGR or small-for-gestational-age (SGA) at birth was assessed using singleton and twin reference charts. Intertwin discordance [(large birthweight − small birthweight)/(large birthweight) × 100%)] was calculated. Logistic regression models were performed. SGA (aOR 2.34, 95% CI 1.60–3.44, p < 0.001), intertwin discordance ≥25% (aOR 2.10, 95% CI 1.26–3.49, p = 0.004) and their co-existence (aOR 2.03, 95% CI 1.16–3.54, p = 0.013) were significantly associated with HDP. After adjusting for the known maternal risk factors of HDP and the intertwin discordance, SGA (using the twin charts) was the strongest independent risk factor associated with HDP (aOR 2.12, 95% CI 1.40–3.22, p < 0.001) and preeclampsia (aOR 2.34, 95% CI 1.45–3.76, p < 0.001). This study highlights that the presence of at least one SGA twin is significantly associated with HDP during pregnancy. Therefore, maternal blood pressure should be closely monitored in twin pregnancies complicated by SGA with or without intertwin discordance.

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Wang, Yao, Ai Zhang, Tineck Stock, Enrico Lopriore, Dick Oepkes, and Qiuzhen Wang. "The accuracy of prenatal diagnosis of selective fetal growth restriction with second trimester Doppler ultrasound in monochorionic diamniotic twin pregnancies." PLOS ONE 16, no. 8 (August 9, 2021): e0255897. http://dx.doi.org/10.1371/journal.pone.0255897.

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Background Selective fetal restriction growth (sFGR) is one of the common diseases of monochorionic diamniotic (MCDA) twin pregnancies, resulting in many adverse outcomes. At present, second trimester ultrasonography is widely used in the prenatal diagnosis of sFGR, but the diagnostic effectiveness is still uncertain. The aim of this study is to assess the diagnostic accuracy of second trimester Doppler ultrasound measurements for sFGR. Methods A retrospective study included 280 pregnant women (118 with and 162 without sFGR) with MCDA pregnancies was conducted in the fetal medicine center from Leiden University Medical Center from January 2008 to December 2013. The women participating had already undergone an ultrasound examination in the second trimester. The postnatal criteria of sFGR was a single birth weight (BW) < 3 rd percentile in a twin, or birth weight discordance (BWD)≥25% between two twins, while the BW of the smaller twin < 10th percentile. Early prenatal diagnosis of sFGR was defined as a single EFW < 3 rd percentile in a twin, or at least 2 of the following 4 parameters must be met (fetal weight of one fetus < 10th percentile, AC of one fetus <10th percentile, EFW discordance≥25%, UA pulsatility index (PI) of the smaller fetus > 95th percentile). According to the diagnosis of sFGR after birth, we evaluate diagnostic effectiveness of Doppler ultrasound in the second trimester for sFGR. Results Of these 280 participants, the mean age was 32.06 ± 4.76 years. About 43.9% of pregnant women were primiparas. The ability of second trimester Doppler ultrasound to accurately diagnosed sFGR is 75.4%, missed diagnosis rate and the misdiagnosis rate were 24.6% and 10.5% respectively. The ROC curve indicated that the combination of AC discordance, EFW discordance, and small fetal UA blood flow was the best diagnostic indicator of sFGR in MCDA pregnancy with the AUC was 0.882 (95%CI, 0.839–0.926). Conclusions Second trimester Doppler and ultrasound measurements is an effective method for early prenatal diagnosis of sFGR. The combined indicator of AC discordance, EFW discordance, and the small fetal UA blood flow reaches highest diagnostic value.

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Oh, Kyung Joon, Jong Kwan Jun, Mi Hyeon Jeong, Chan-Wook Park, and Joong Shin Park. "432: Fetal inflammatory responses of twin pairs with birth weight discordance." American Journal of Obstetrics and Gynecology 201, no. 6 (December 2009): S165. http://dx.doi.org/10.1016/j.ajog.2009.10.598.

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Ropacka-Lesiak, Mariola, Grzegorz Bręborowicz, and Anna Dera. "Blood Flow Changes in Dichorionic Twins With Growth Discordance." Twin Research and Human Genetics 15, no. 6 (August 10, 2012): 781–87. http://dx.doi.org/10.1017/thg.2012.51.

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Aim: The study evaluated the applicability of Doppler ultrasonography in predicting the course of pregnancy and neonatal outcome in dichorionic pregnancy complicated by growth discordance. Methods: Doppler examination of the umbilical artery (UA) and middle cerebral artery (MCA) was performed in 106 twins. Abnormal values of the UA pulsatility index (PI) were considered to be above the 95th percentile and below 5th percentile for the MCA PI for gestational week. The difference of UA PI ≥0.5 in twin pairs was considered abnormal. Doppler results were compared with selected parameters that characterize the course of pregnancy and fetal outcome. Results: Abnormal UA PI as well as the intertwine PI difference of 0.5 and more correlated significantly with lower gestational age at delivery, intertwine growth discordance of 35% or more, lower birth weight, and abnormal fetal outcome. The abnormal cerebro-umbilical (C/U) ratio correlated statistically with lower birth weight, abnormal fetal outcome, and an increased risk of premature delivery. There were no statistically significant differences in the majority of parameters that characterize the neonatal outcome between the groups with normal and abnormal MCA PI. Conclusion: The intertwine UA PI difference ≥0.5 had the highest predictive value in the assessment of adverse fetal outcome and risk for small for gestational age (SGA). Relatively poor sensitivity was noted with regard to the abnormal values of UA PI and C/U ratio. The worse correlation was found in case of MCA PI.

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Boo, H., S. Kim, Y. Han, M. Kim, Y. Lee, and J. Chung. "P19.08: Sonographically estimated fetal weight discordance and perinatal outcomes in twin pregnancies." Ultrasound in Obstetrics & Gynecology 52 (October 2018): 189. http://dx.doi.org/10.1002/uog.19774.

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Diaz-Garcia, C., L. J. Salomon, J. P. Bernard, J. Stirnemann, S. Fortuno, and Y. Ville. "OP16.08: Accuracy of sonographic prediction of fetal weight discordance in twin pregnancies." Ultrasound in Obstetrics and Gynecology 32, no. 3 (August 2008): 366. http://dx.doi.org/10.1002/uog.5793.

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Stirnemann, J., J. C. Thalabard, J. C. Salomon, J. P. Bernard, and Y. Ville. "OP16.09: Fetal weight discordance in twin pregnancies: Lessons from a longitudinal study." Ultrasound in Obstetrics and Gynecology 32, no. 3 (August 2008): 366–67. http://dx.doi.org/10.1002/uog.5794.

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Kato, Noriko, and Tomohiro Matsuda. "The Relationship Between Birthweight Discordance and Perinatal Mortality of One of the Twins in a Twin Pair." Twin Research and Human Genetics 9, no. 2 (April 1, 2006): 292–97. http://dx.doi.org/10.1375/twin.9.2.292.

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AbstractThis study aimed to evaluate the prevalence of birth-weight discordance among twins, to determine the risk cut-off point for birthweight discordance, and to clarify whether perinatal deaths are aggravated by birthweight discordance or by low birthweight itself. A population-based analysis of all twins born between 1995 and 1999 in Japan was conducted using data collected from national birth, death and stillbirth certificates. Birthweight discordance was determined as: higher birthweight minus lower birthweight divided by higher birthweight multiplied by 100. Among twins with a birthweight discordance of more than 15%, the fetal and perinatal mortality rate was higher than that of twins with a discordance of less than 15%. Ninety per cent of the relative cumulative frequency of twin live-births were within 25% of the birthweight discordance. Logistic regression analysis showed that the stillbirth of at least one of the twins is associated with the birthweight of the larger twin and birthweight discordance. It also showed that the stillbirth of both twins in the twin pair is associated with the birth-weight of larger twins and the gestational weeks. It was clarified that birthweight discordance was associated with the stillbirth of only one twin in the twin pair, and the stillbirth of both twins in the twin pair was associated with low birthweight itself.

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Algeri, Paola, Matteo Frigerio, Maria Lamanna, Petya Vitanova Petrova, Sabrina Cozzolino, Maddalena Incerti, Salvatore Andrea Mastrolia, Nadia Roncaglia, and Patrizia Vergani. "Selective IUGR in dichorionic twins: what can Doppler assessment and growth discordancy say about neonatal outcomes?" Journal of Perinatal Medicine 46, no. 9 (November 27, 2018): 1028–34. http://dx.doi.org/10.1515/jpm-2017-0253.

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Abstract Objective: The aim of the present study was to assess, in a population of dichorionic twin pregnancies with selective growth restriction, the effect of inter-twin differences by use of Doppler velocimetry and fetal growth discordancy on perinatal outcomes. Methods: This was a retrospective study including dichorionic twin pregnancies from January 2008 to December 2015 at the Department of Obstetrics and Gynecology of Fondazione MBBM. Only dichorionic twin pregnancies affected by selective intrauterine growth restriction (IUGR) delivering at ≥24 weeks were included in the study. Results: We found that twin pregnancies with inter-twin estimated fetal weight (EFW) discordance ≥15% were significantly associated with a higher risk of preterm delivery before 32 (P=0.004) and 34 weeks (P=0.04). Similarly, twin pregnancies with inter-twin abdominal circumference (AC) discordance ≥30° centiles were associated with a higher rate of neonatal intensive care unit (NICU) admission (P=0.02), neonatal resuscitation (P=0.02) and adverse neonatal composite outcome (P=0.04). Of interest, when comparing twin pregnancies according to Doppler study, growth restricted twins had a higher rate of composite neonatal outcome and in multivariate analysis, an abnormal Doppler was an independent risk factor for this outcome. Conclusions: Our study associated growth discrepancy with specific pregnancy outcomes, according to defined cut-offs. In addition, we demonstrated that an abnormal umbilical artery Doppler is independently associated with a composite neonatal adverse outcome in growth restricted fetuses.

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Neves, Ana Raquel, Filipa Nunes, Miguel Branco, Maria do Céu Almeida, and Isabel Santos Silva. "The role of ultrasound in the prediction of birth weight discordance in twin pregnancies: are we there yet?" Journal of Perinatal Medicine 46, no. 2 (February 23, 2018): 163–68. http://dx.doi.org/10.1515/jpm-2016-0371.

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AbstractObjective:To analyze the accuracy of ultrasound prediction of birth weight discordance (BWD) and the influence of chorionicity and fetal growth restriction (FGR) on ultrasound performance.Methods:Retrospective analysis of 176 twin pregnancies at a Portuguese tertiary center, between 2008 and 2014. Last ultrasound biometry was recorded. Cases with delivery before 24 weeks, fetal malformations, interval between last ultrasound and deliver >3 weeks, twin-to-twin transfusion syndrome and monoamniotic pregnancies were excluded. The accuracy of prediction of BWD was assessed using the area under the receiver-operating characteristics curve (AUC).Results:BWD ≥20% was present in 21.6% of twin pregnancies. EBW had the best predictive performance for BWD (AUC 0.838, 95%CI 0.760–0.916), with a negative predictive value of 86.9% and a positive predictive value of 51.3%. Chorionicity did not influence ultrasound performance. None of the biometric variables analyzed was predictive of BWD in pregnancies without FGR.Conclusion:The accuracy of ultrasound in the prediction of BWD is limited, particularly in pregnancies without fetal growth restriction. Clinical decisions should not rely on BWD alone.

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JACOBS, A. "Birth weight discordance and adverse fetal and neonatal outcomes among triplets in the United States." Obstetrics & Gynecology 101, no. 5 (May 2003): 909–14. http://dx.doi.org/10.1016/s0029-7844(02)03080-6.

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Jacobs, Andrea R., Kitaw Demissie, Neetu J. Jain, and Wendy L. Kinzler. "Birth Weight Discordance and Adverse Fetal and Neonatal Outcomes Among Triplets in the United States." Obstetrics & Gynecology 101, no. 5, Part 1 (May 2003): 909–14. http://dx.doi.org/10.1097/00006250-200305000-00015.

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D'Antonio, F., S. Pescarini, T. D. Dias, A. Bhide, and B. Thilaganathan. "OC22.03: Twin estimated fetal weight discordance and adverse pregnancy outcome: the STORK multiple pregnancy cohort." Ultrasound in Obstetrics & Gynecology 40, S1 (September 2012): 45. http://dx.doi.org/10.1002/uog.11363.

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Bhide, A., S. Sankaran, S. Sairam, A. T. Papageorghiou, and B. Thilaganathan. "Relationship of intertwin crown-rump length discrepancy to chorionicity, fetal demise and birth-weight discordance." Ultrasound in Obstetrics and Gynecology 34, no. 2 (August 2009): 131–35. http://dx.doi.org/10.1002/uog.6396.

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Queirós, Alexandra, Isaac Blickstein, Sandra Valdoleiros, Nisa Felix, Alvaro Cohen, and Teresinha Simões. "Prediction of birth weight discordance from fetal weight estimations at 21–24 weeks' scans in monochorionic and dichorionic twins." Journal of Maternal-Fetal & Neonatal Medicine 30, no. 16 (February 7, 2017): 1944–47. http://dx.doi.org/10.1080/14767058.2016.1233397.

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Bebbington, M., N. Khalek, J. Moldenhauer, and M. P. Johnson. "OP15.02: Estimated fetal weight (EFW) discordance in twin-to-twin transfusion syndrome: what does it mean?" Ultrasound in Obstetrics & Gynecology 40, S1 (September 2012): 99. http://dx.doi.org/10.1002/uog.11530.

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Neves, Ana Raquel, Filipa Nunes, Miguel Branco, Maria do Céu Almeida, and Isabel Santos Silva. "The influence of fetal growth restriction on ultrasound prediction of birth weight discordance in twin pregnancies." European Journal of Obstetrics & Gynecology and Reproductive Biology 206 (November 2016): e172. http://dx.doi.org/10.1016/j.ejogrb.2016.07.423.

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Khalil, A., F. D'Antonio, M. Warren, T. D. Dias, and B. Thilaganathan. "OP21.10: Birthweight and estimated fetal weight discordance and neonatal morbidity in twins: the STORK multiple pregnancy cohort." Ultrasound in Obstetrics & Gynecology 42, s1 (October 2013): 110–11. http://dx.doi.org/10.1002/uog.12907.

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Amyx, Melissa M., Paul S. Albert, Alaina M. Bever, Stefanie N. Hinkle, John Owen, William A. Grobman, Roger B. Newman, et al. "Associations between estimated foetal weight discordance and clinical characteristics within dichorionic twins: The NICHD Fetal Growth Studies." Paediatric and Perinatal Epidemiology 33, no. 5 (September 2019): 332–42. http://dx.doi.org/10.1111/ppe.12570.

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Chang, Yao-Lung, An-Shine Chao, Hsiu-Huei Peng, Shuenn-Dyh Chang, Sheng-Yuan Su, Kuan-Ju Chen, Po-Jen Cheng, and Tzu-Hao Wang. "Increased Fetal Plasma Erythropoietin in Monochorionic Twin Pregnancies With Selective Intrauterine Growth Restriction and Abnormal Umbilical Artery Doppler." Twin Research and Human Genetics 19, no. 4 (May 10, 2016): 383–88. http://dx.doi.org/10.1017/thg.2016.38.

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Hypoxia is the primary stimulus for the production of erythropoietin (EPO) in both fetal and adult life. Here, we investigated fetal plasma EPO concentrations in monochorionic (MC) twin pregnancies with selective intrauterine growth restriction (sIUGR) and abnormal umbilical artery (UA) Doppler. We diagnosed sIUGR in presence of (1) birth-weight discordance >20% and (2) either twin with a birth weight <10th percentile. An abnormal UA Doppler was defined as a persistent absent-reverse end diastolic flow (AREDF). The intertwin EPO ratio was calculated as the plasma EPO level of the smaller (or small-for-gestational-age) twin divided by the EPO concentration of the larger (or appropriate-for-gestational-age (AGA)) twin. Thirty-two MC twin pairs were included. Of these, 17 pairs were normal twins (Group 1), seven pairs were twins with sIUGR without UA Doppler abnormalities (Group 2), and eight pairs were twins with sIUGR and UA Doppler abnormalities (Group 3). The highest EPO ratio was identified in Group 3 (p< .001) but no significant differences were observed between Groups 1 and 2. Fetal hemoglobin levels did not differ significantly in the three groups, and fetal EPO concentration did not correlate with gestational age at birth. We conclude that fetal plasma EPO concentrations are selectively increased in MC twin pregnancies with sIUGR and abnormal UA Doppler, possibly as a result of uncompensated hypoxia.

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Lopriore, Enrico, Carolien Sluimers, Suzanne A. Pasman, Johanna M. Middeldorp, Dick Oepkes, and Frans J. Walther. "Neonatal Morbidity in Growth-Discordant Monochorionic Twins: Comparison Between the Larger and the Smaller Twin." Twin Research and Human Genetics 15, no. 4 (July 5, 2012): 541–46. http://dx.doi.org/10.1017/thg.2012.26.

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Fetal growth restriction in singletons has been shown to enhance fetal lung maturation and reduce the risk of respiratory distress syndrome due to increased endogenous steroid production. However, data on lung maturation in growth-discordant monochorionic (thus, identical) twins are lacking. Our objective was to compare the risk of severe neonatal morbidity between the larger and the smaller twin in monochorionic twins with birth weight discordance (BWD). We included in the study all consecutive monochorionic diamniotic pregnancies with severe BWD (≥25%) and two live-born twins delivered at our center (n = 47 twin pairs). We compared the incidence of neonatal morbidity, particularly respiratory distress syndrome (RDS), and cerebral lesions between the larger and the smaller co-twin. The incidence of severe neonatal morbidity in the larger and smaller twin was 38% (18/47) and 19% (9/47), respectively (odds ratio (OR) 2.66, 95% confidence interval (CI) 0.94–7.44) and was due primarily to the higher incidence of RDS, 32% (15/47) and 6% (3/47), respectively (OR 6.88, 95% CI 1.66–32.83). In conclusion, this study shows that the larger twin in monochorionic twin pairs with BWD is at increased risk of severe neonatal morbidity, particularly RDS, compared to the smaller twin.

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Demissie, K. "Fetal and neonatal mortality among twin gestations in the United States: the role of intrapair birth weight discordance." Obstetrics & Gynecology 100, no. 3 (September 2002): 474–80. http://dx.doi.org/10.1016/s0029-7844(02)01951-8.

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Al-Obaidly, Sawsan, Jacqueline Parrish, Kellie E. Murphy, Phyllis Glanc, and Cynthia Maxwell. "The Accuracy of Estimating Fetal Weight and Inter-Twin Weight Discordance by Ultrasound in Twin Pregnancies in Women With Increased Body Mass Index." Journal of Obstetrics and Gynaecology Canada 37, no. 8 (August 2015): 696–701. http://dx.doi.org/10.1016/s1701-2163(15)30173-0.

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Franklin, Andrew, Sushmita Yallapragada, Robert Birkett, William Grobman, Linda M. Ernst, and Karen Mestan. "The impact of placental pathology discordance in multiple gestation pregnancies on bronchopulmonary dysplasia-associated pulmonary hypertension." Pulmonary Circulation 10, no. 1 (January 2020): 204589402091067. http://dx.doi.org/10.1177/2045894020910674.

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Bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) may either be concordant or discordant between multiple gestation births. Abnormal placental development, particularly maternal vascular malperfusion, may account for discordance in BPD-PH through fetal programming mechanisms. Maternal vascular malperfusion is a placental histologic lesion associated with intrauterine growth restriction and BPD-PH. We conducted a retrospective longitudinal cohort study of infants born <29 weeks gestation with available placental histology at Prentice Women's Hospital in Chicago from 2005–2012. The primary outcome was discordant BPD-PH associated with placental maternal vascular malperfusion. We secondarily assessed whether the risk of BPD-PH and placental lesions was different among infants of multiple (compared to singleton) gestations. The cohort consisted of 135 multiple gestation infants and 355 singletons. In a separate cohort of 39 singletons and 35 multiples, associations between 12 cytokines and angiogenic growth factors in cord blood plasma for biomarker discordance, maternal vascular malperfusion, and bronchopulmonary dysplasia were explored. Among multiples, discordant maternal vascular malperfusion was not associated with BPD-PH (OR = 1.9 (0.52, 6.9); p = 0.33) in infants exposed to placental maternal vascular malperfusion. However, singleton infants were more likely to develop BPD-PH (compared to multiples) after adjusting for mode of delivery, chorioamnionitis, chronic hypertension, placental abruption, small-for-gestational age birth weight, and gestational age (aOR = 2.7 (1.2, 5.8); p = 0.038). Singletons were more likely to be small-for-gestational age (11% vs 4%, p = 0.025) and have placental lesions compared to their multiple-gestation counterparts (96% vs 81%, p < 0.001), principally severe maternal vascular malperfusion (17% vs 4%, p < 0.001) and chronic inflammation (32% vs 11%, p < 0.001). Increased risk of BPD-PH in singleton pregnancies <29 weeks gestation compared to multiples may be related to increased frequency of these histologic lesions. Placental pathology in singleton and multiple gestation pregnancies may serve as an early biomarker to predict BPD-PH.

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Sharma, Sanjay Kumar, Reema Kumar Bhatt, Anupam Kapur, and Shakti Panda. "Clinical study comparing outcome of post in vitro fertilisation triplet pregnancy reduced to twins versus non reduced in vitro fertilisation triplet pregnancies." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 11 (October 23, 2019): 4191. http://dx.doi.org/10.18203/2320-1770.ijrcog20194593.

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Background: There has been an upsurge in the number of multiple pregnancies with its attributability to increasing use of artificial reproductive techniques. To study clinical outcome of post IVF triplet pregnancy reduced to twin pregnancies compared to those without triplet reduction.Methods: Hospital designed comparative study. 31 subjects were studied for comparative study design with triplets obtained after infertility treatment (assisted post-IVF). Out of 31, 15 subjects were expectantly managed who refused reduction while 16 subjects chose reduction to twins. Outcomes like prematurity, complications in neonate, birth weight discordance, neonatal mortality and maternal complications were studied.Results: The fetal (triplet) reduction group was associated with significant (p<0.002) higher neonatal birth weight as compared to non-reduced group. The fetal reduction group had significantly lower incidence of prematurity and neonatal complications like hyperbilirubinemia, respiratory distress syndrome and neonatal sepsis. The maternal complications were also higher in nonreduced in terms of PPROM, gestational hypertension, gestational diabetes mellitus, intrahepatic cholestasis of pregnancy and gestational hypertension.Conclusions: It is indicated that the reduction of triplet to twins is effective considering more complications with non-reduced group and hence reduction improves favorable pregnancy outcomes.

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Swamy, Ravi Shankar, Helen McConachie, Jane Ng, Judith Rankin, Murthy Korada, Stephen Sturgiss, and Nicholas D. Embleton. "Cognitive outcome in childhood of birth weight discordant monochorionic twins: the long-term effects of fetal growth restriction." Archives of Disease in Childhood - Fetal and Neonatal Edition 103, no. 6 (March 2, 2018): F512—F516. http://dx.doi.org/10.1136/archdischild-2017-313691.

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AimIntrauterine growth restriction (IUGR) is associated with poorer outcomes in later life. We used a monochorionic twin model with IUGR in one twin to determine its impact on growth and neurocognitive outcomes.MethodsMonochorionic twins with ≥20% birth weight discordance born in the north of England were eligible. Cognitive function was assessed using the British Ability Scales. The Strength and Difficulties Questionnaire was used to identify behavioural problems. Auxological measurements were collected. Generalised estimating equations were used to determine the effects of birth weight on cognition.ResultsFifty-one monochorionic twin pairs were assessed at a mean age of 6.3 years. Mean birth weight difference was 664 g at a mean gestation of 34.7 weeks. The lighter twin had a General Conceptual Ability (GCA) score that was three points lower (TwinL −105.4 vs TwinH −108.4, 95% CI −0.9 to −5.0), and there was a significant positive association (B 0.59) of within-pair birth weight differences and GCA scores. Mathematics and memory skills showed the largest differences. The lighter twin at school age was shorter (mean difference 2.1 cm±0.7) and lighter (mean difference 1.9 kg±0.6). Equal numbers of lighter and heavier twins were reported to have behavioural issues.ConclusionsIn a monochorionic twin cohort, fetal growth restriction results in lower neurocognitive scores in early childhood, and there remain significant differences in size. Longer term follow-up will be required to determine whether growth or cognitive differences persist in later child or adulthood, and whether there are any associated longer term metabolic sequelae.

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Aquino, Carolina, Ana Elisa Rodrigues Baião, and Paulo Roberto Nassar de Carvalho. "Perinatal Outcome of Selective Intrauterine Growth Restriction in Monochorionic Twins: Evaluation of a Retrospective Cohort in a Developing Country." Twin Research and Human Genetics 24, no. 1 (February 2021): 37–41. http://dx.doi.org/10.1017/thg.2021.7.

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AbstractSelective intrauterine growth restriction (sIUGR) in monochorionic twin pregnancies is associated with greater morbidity and mortality for both fetuses when compared to singleton and dichorionic pregnancies. This retrospective cohort study aimed to assess the perinatal outcomes of monochorionic twin pregnancies affected by this disorder and conducted expectantly, by analyzing the results according to the end-diastolic flow in the umbilical artery Doppler of the smaller twin (type I: persistently forward/type II: persistently absent or reversed/type III: intermittently absent or reversed). Seventy-five monochorionic diamniotic twin pregnancies with sIUGR were included in this study. sIUGR was defined by estimated fetal weight below the 3rd centile for gestational age, or below the 10th centile, when associated with at least one of the following three criteria: abdominal circumference below the 10th percentile, umbilical artery pulsatility index of the smaller twin above the 95th percentile, or estimated fetal weight discordance of 25% or more. Perinatal outcomes were analyzed from the prenatal period to hospital discharge and included perinatal death, neurological injury, retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and sepsis. The mortality rate was 1.33% in this cohort. The overall morbidity rate was lower in type I twin pregnancies. In conclusion, this study shows that sIUGR type I has lower morbidity than types II and III in expectant management.

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Groene, Sophie G., Lisanne S. A. Tollenaar, Dick Oepkes, Enrico Lopriore, and Jeanine M. M. van Klink. "The Impact of Selective Fetal Growth Restriction or Birth Weight Discordance on Long-Term Neurodevelopment in Monochorionic Twins: A Systematic Literature Review." Journal of Clinical Medicine 8, no. 7 (June 28, 2019): 944. http://dx.doi.org/10.3390/jcm8070944.

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The aim of this review was to assess the impact of selective fetal growth restriction (sFGR) and/or birth weight discordance (BWD) on long-term neurodevelopment in monochorionic (MC) twins. Five out of 28 articles assessed for eligibility were included. One article concluded that the incidence of long-term neurodevelopmental impairment (NDI) was higher in BWD MC twins (11/26, 42%) than in BWD dichorionic (DC) (5/38, 13%) and concordant MC twins (6/71, 8%). BWD MC twins had a 6-fold higher risk of cerebral palsy compared to DC twins (5/26, 19% vs. 1/40, 3%, p < 0.05). Another article described a linear relationship between birth weight and verbal IQ scores, demonstrating a 13-point difference for a 1000 gram BWD between the twins, with a disadvantage for the smaller twin (p < 0.0001). Three articles analyzing within-pair differences showed that the smaller twin more frequently demonstrated mild NDI (6/80, 8% vs. 1/111, 1%) and lower developmental test scores (up to 5.3 points) as opposed to its larger co-twin. Although these results suggest that MC twins with sFGR/BWD are at increased risk of long-term NDI as compared to BWD DC or concordant MC twins, with a within-pair disadvantage for the smaller twin, the overall level of evidence is of moderate quality. As only five articles with a high degree of heterogeneity were available, our review mainly demonstrates the current lack of knowledge of the long-term outcomes of MC twins with sFGR/BWD. Insight into long-term outcomes will lead to improved prognostics, which are essential in parent counseling and crucial in the process of forming a management protocol specifically for twins with sFGR to optimally monitor and support their development.

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Segal, Nancy L. "College-Age Twins: University Admission Policies / Twin Research: Birth Weight and Neuromotor Performance; Transfusion Syndrome Markers; Vanishing Twins and Fetal Sex Determination; MZ Twin Discordance for Wilson's Disease / Media: Big at Birth; Planned Separation of Conjoined Twins; X Factor Twins; Cinema: The Identical." Twin Research and Human Genetics 17, no. 6 (October 21, 2014): 594–98. http://dx.doi.org/10.1017/thg.2014.66.

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There is a lack of research findings addressing the unique college admissions issues faced by twins and other multiples. The advantages and disadvantage twins face, as reported by college administrators, twins and families are reviewed. Next, recent research addressing twins’ birth weight and neuromotor performance, transfusion syndrome markers, the vanishing twin syndrome and monozygotic (MZ) twin discordance for Wilson's disease is described. News items concerning the birth of unusually large twins, the planned separation of conjoined twins, twin participants in the X Factor games and a film, The Identical, are also summarized.

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Henriksen, Tine Brink, Gerda Elisabeth Villadsen, Morten Hedegaard, and Niels J. Secher. "Prediction of light-for-gestational age at delivery in twin pregnancies: an evaluation of fetal weight deviation and growth discordance measured by ultrasound." European Journal of Obstetrics & Gynecology and Reproductive Biology 47, no. 3 (December 1992): 195–200. http://dx.doi.org/10.1016/0028-2243(92)90151-n.

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Geipel, A., C. Berg, U. Germer, A. Katalinic, M. Krapp, J. Smrcek, and U. Gembruch. "Doppler assessment of the uterine circulation in the second trimester in twin pregnancies: prediction of pre-eclampsia, fetal growth restriction and birth weight discordance." Ultrasound in Obstetrics and Gynecology 20, no. 6 (December 2002): 541–45. http://dx.doi.org/10.1046/j.1469-0705.2002.00866.x.

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Lee, Hyun-Mi, SiWon Lee, Min-Kyung Park, You Jung Han, Moon Young Kim, Hye Yeon Boo, and Jin Hoon Chung. "Clinical Significance of Velamentous Cord Insertion Prenatally Diagnosed in Twin Pregnancy." Journal of Clinical Medicine 10, no. 4 (February 3, 2021): 572. http://dx.doi.org/10.3390/jcm10040572.

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Background: The purpose of this study was to evaluate the prevalence of velamentous cord insertion (VCI) and the actual association between pathologically confirmed VCI and perinatal outcomes in twins based on the chorionicity. Methods: All twin pregnancies that received prenatal care at a specialty clinic for multiple pregnancies, from less than 12 weeks of gestation until delivery in a single institution between 2015 and 2018 were included in this retrospective cohort study. Results: A total of 941 twins were included in the study. The prevalence of VCI in dichorionic (DC) twins and monochorionic diamniotic (MCDA) twins was 5.8% and 7.8%, respectively (p = 0.251). In all study population, the prevalence of vasa previa and placenta accreta spectrum was higher in VCI group than that of non-VCI group (p = 0.008 and 0.022). In MCDA twins with VCI, birth weight, 1 and 5-min Apgar score were lower than DC twins with VCI (p = 0.010, 0.002 and 0.000). There was no significant association between VCI and selective fetal growth restriction (p = 0.486), twin-to-twin transfusion syndrome (p = 0.400), and birth-weight discordance (>20% and >25%) (p = 0.378 and 0.161) in MCDA twins. Conclusion: There was no difference in the incidence of VCI in twins based on the chorionicity. Moreover, VCI was not a risk factor for adverse perinatal outcomes excepting vasa previa and placenta accreta spectrum, which had a high incidence in twins with VCI.

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Sooranna, Suren R., Stuart Ward, and Rekha Bajoria. "Fetal Leptin Influences Birth Weight in Twins with Discordant Growth." Pediatric Research 49, no. 5 (May 2001): 667–72. http://dx.doi.org/10.1203/00006450-200105000-00010.

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Yeo, Lami, Cande Ananth, Martin Chavez, John Smulian, and Anthony Vintzileos. "The effect of placental chorionicity on estimated fetal weight discordancy in twin gestations." American Journal of Obstetrics and Gynecology 193, no. 6 (December 2005): S158. http://dx.doi.org/10.1016/j.ajog.2005.10.633.

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Sobhani, Nasim C., Teresa N. Sparks, Kristen A. Gosnell, Juan Gonzalez, and Vickie A. Feldstein. "911: Fetal growth restriction in smaller twin of monochorionic diamniotic pair with discordant estimated fetal weights." American Journal of Obstetrics and Gynecology 220, no. 1 (January 2019): S588—S589. http://dx.doi.org/10.1016/j.ajog.2018.11.935.

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Sadrzadeh, Sheda, Susan A. Treloar, G. Caroline M. van Baal, and Cornelis B. Lambalk. "Potential Bias Regarding Birth Weight in Historical and Contemporary Twin Data Bases." Twin Research 4, no. 5 (October 1, 2001): 332–36. http://dx.doi.org/10.1375/twin.4.5.332.

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AbstractIn this study we examine the hypothesis that monozygotic (MZ) twins in historical databases are less discordant for birth weight due to negative selection of severely discordant MZ twins. Furthermore, we test the hypothesis that MZ twins are less discordant for birth weight when comparing a volunteer based twin registry with a population based twin registry, due to selective registration. Data were available on 3927 twin pairs from the volunteer Australian Twin Registry born before 1964, 3059 volunteer twin pairs from the Netherlands Twin Register born 1987–1989 and 454 Belgian twin pairs from The East Flanders Prospective Twin Survey born 1987–1989. Intrapair relative birth weight differences (RBWD) were computed for MZ and dizygotic (DZ) twins from each twin registry. Comparing birth weight differences between MZ and DZ twins provides support for the hypothesis that MZ twins are subject to a negative selection in historical databases. Furthermore, Australian MZ twins have a lower RBWD compared to Dutch MZ twins when corrected for the RBWD of Australian and Dutch DZ twins, indicating circumstances which only affect MZ twins. Our hypothesis that MZ twins are less discordant for birth weight in a volunteer based twin registry compared to a population based twin registry had to be rejected. We suggest that investigators using historical databases to test the fetal origins hypothesis should be aware of this increased likelihood of selective exclusion of individuals with extreme morphometric parameters at time of birth.

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Denize, Kathryn M., Nina Acharya, Stephanie A. Prince, Danilo Fernandes da Silva, Alysha L. J. Harvey, Zachary M. Ferraro, and Kristi B. Adamo. "Addressing cultural, racial and ethnic discrepancies in guideline discordant gestational weight gain: a systematic review and meta-analysis." PeerJ 6 (August 27, 2018): e5407. http://dx.doi.org/10.7717/peerj.5407.

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Objective To systematically review the literature and describe the discrepancies in achieving the 2009 Institute of Medicine (IOM) gestational weight gain (GWG) guidelines across cultures. Methods Ten databases were searched from inception to April 2018. Observational cohort studies were included that examined adult women; reported on a measure of culture; compared cultural groups, and reported on GWG. Articles were broken down into papers that used the current 2009 IOM GWG guidelines and those that used others. A meta-analysis was conducted for studies using the 2009 guidelines examining the prevalence of discordant GWG across cultural groups. Results The review included 86 studies. Overall, 69% of women experienced discordant GWG irrespective of culture. White women experienced excessive GWG most often, and significantly more than Asian and Hispanic women; Black women had a higher prevalence of excessive GWG than Hispanic and Asian women; however, this difference was not significant. Conclusions The majority of women experience excessive GWG, with White women experiencing this most often. Culturally diverse GWG guidelines are needed to individualize antenatal care and promote optimal maternal-fetal health outcomes across cultural groups.

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Gohlke, Bettina C., Peter Bartmann, Rolf Fimmers, Agnes Huber, Kurt Hecher, and Christian L. Roth. "Fetal Adiponectin and Resistin in Correlation with Birth Weight Difference in Monozygotic Twins with Discordant Growth." Hormone Research in Paediatrics 69, no. 1 (September 25, 2006): 37–44. http://dx.doi.org/10.1159/000111794.

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Mathew, Rachel, Vinitha Wills, and Jacob Abraham. "Maternal determinants and fetal outcome of twin pregnancy: a five-year survey." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 6 (May 25, 2017): 2459. http://dx.doi.org/10.18203/2320-1770.ijrcog20172331.

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Background: Study prevalence of twin pregnancy, maternal risk factors and fetal outcome in twin pregnancy.Methods: A retrospective study of mothers with twin pregnancies who delivered during the period of 5 years. There were 109 mothers who gave birth to 218 babies. Maternal details, antenatal complications and fetal outcomes were analysed.Results: There were 5432 deliveries which included 109 twin births. Prevalence of twinning was 20/1000 deliveries. The mean age was 28.11 (±SD 4.89) with 69.7% in the younger age groups. No association with parity, BMI and ovulation induction was found. Most common complication was preterm delivery (64.2%) with mean gestational age being 35.07 (±SD 2.32). Others were diabetes (25.7%), hypertension (22.9%), hypothyroidism (14.6%) and postpartum hemorrhage (13.7%). Cesarean section was the commonest mode of delivery (78.0%) with fetal malpresentation (26.6%), fetal distress (20.2%) and hypertension (12.0%) being the commonest indications for termination. Among the hypertensive mothers, 23 delivered by Cesarean and only 2 delivered vaginally which was statistically significant (p- 0.03 OR 5.20). Dichorionicity was commoner than monochorionicity (66.1% vs. 33.9%). Among 218 fetuses delivered, 214 were live births and 4 still born. There were low birth weight Babies (70.6%), normal weight (15.3%), VLBW babies (11.5%) and 2.7% ELBW babies. Fetal complications were IUGR (11.46%), discordant twins (6.8%), congenital anomalies (1.8%), single fetal demise (1.8%) and Intra uterine death of a twin (0.4%). Perinatal mortality rate was 1.65 per thousand births.Conclusions: Prevalence of twin pregnancy was 20/1000 deliveries. Twin pregnancies were seen to be more in the younger age group. Preterm labor, diabetes and hypertension were the main complications with cesarean the most common mode of delivery. Dichorionicity led to less fetal complications and low perinatal mortality.

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Journal articles on the topic 'Fetal weight discordance'

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