Perinatal complications of monochorionic diamniotic twin gestations with discordant crown–rump length determined at mid‐first trimester. Issue 2 (7th October 2013)

• Record Type: Journal Article
• Authors: Nakayama, Soichiro; Ishii, Keisuke; Kawaguchi, Haruna; Yamamoto, Ryo; Murata, Masaharu; Hayashi, Shusaku; Mitsuda, Nobuaki
• Is Part Of: Journal of obstetrics and gynaecology research. Volume 40:Issue 2(2014:Feb.)
• Page Start: 418
• Page End: 423
• Publication Date: 2013-10-07
• Subjects: Gynecology -- Periodicals; Obstetrics -- Periodicals; 618.1005
• DOI: 10.1111/jog.12178
• Languages: English
• ISSNs: 1341-8076

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jog12178-sec-0001" sec-type="section"> <title>Aim</title> <p>The aim of this study was to investigate the value of discordance of crown–rump length (DCRL) at mid‐first trimester to predict adverse outcomes in monochorionic diamniotic twin gestations (MD).</p> </sec> <sec id="jog12178-sec-0002" sec-type="section"> <title>Material and Methods</title> <p>This was a retrospective cohort study of the perinatal outcome in MD pregnancies managed from the first trimester onward. DCRL was evaluated between 8 and 10 weeks of gestation. The association between DCRL and perinatal complications, including fetal death, twin–twin transfusion syndrome, severe discordant birthweight (DB), and twin anemia‐polycythemia sequence, was assessed.</p> </sec> <sec id="jog12178-sec-0003" sec-type="section"> <title>Results</title> <p>Among 126 cases, a single fetal demise occurred in two (2%) and demise of both fetuses occurred in eight (6%). Five pregnancies (4%) were complicated with twin–twin transfusion syndrome; one case (1%) was twin anemia‐polycythemia sequence and 13 (10%) were DB. Neonatal death occurred in one pair. At 28 days of age, in 115 cases (91%) both twins were alive. In 117 cases (93%), at least one twin survived until 28 days of age. DCRL >12.0% was not related to any perinatal complications but DB (<italic>P</italic> < 0.01; relative risk: 1.40; 95% confidence interval: 1.06–1.84).</p> </sec> <sec id="jog12178-sec-0004" sec-type="section"> <title>Conclusions</title> <p>DCRL in MD during the mid‐first trimester might be useful for predicting DB.</p> </sec> </abstract>