Fetal growth reference ranges in twin pregnancy: analysis of the Southwest Thames Obstetric Research Collaborative (STORK) multiple pregnancy cohort. (25th August 2014)

• Record Type: Journal Article
• Authors: Stirrup, O. T.; Khalil, A.; D'Antonio, F.; Thilaganathan, B.
• Other Names: Bahamie Arash investigator.; Bhide Amar investigator.; Deans Anne investigator.; Egbor Michael investigator.; Ellis Cheryl investigator.; Gandhi Hina investigator.; Hamid Rosol investigator.; Hutt Renata investigator.; Matiluko Adetunji investigator.; Morgan Kim investigator.; Pakarian Faz investigator.; Papageorghiou Aris investigator.; Peregrine Elisabeth investigator.; Roberts Lesley investigator.
• Is Part Of: Ultrasound in obstetrics & gynecology. Volume 45:Number 3(2015:Mar.)
• Page Start: 301
• Page End: 307
• Publication Date: 2014-08-25
• Subjects: dichorionic diamniotic -- fetal growth -- monochorionic diamniotic -- multiple pregnancy -- twin pregnancy -- ultrasound; Ultrasonics in obstetrics -- Periodicals; Generative organs, Female -- Diseases -- Diagnosis -- Periodicals; Diagnosis, Ultrasonic -- Periodicals; Genital Diseases, Female -- ultrasonography -- Periodicals; Ultrasonography, Prenatal -- Periodicals; 618.047543
• DOI: 10.1002/uog.14640
• Languages: English
• ISSNs: 0960-7692

Abstract

Abstract: Objective: To generate reference charts for expected fetal growth in dichorionic diamniotic (DCDA) and monochorionic diamniotic (MCDA) twin pregnancies and to compare these with those from singleton pregnancies. Methods: This was a retrospective study of biometric measurements from serial ultrasound examinations of twin pregnancies in the second and third trimesters, from 14 weeks' gestation to term, collected by nine hospitals over a 10‐year period. The measurements obtained in each fetus at each examination included head circumference (HC), biparietal diameter (BPD), abdominal circumference (AC) and femur length (FL). Multilevel mixed effects statistical models were used to evaluate growth in each biometric variable in relation to gestational age, taking account of the serial examinations and the association between the two fetuses in each pregnancy, with separate models constructed for DCDA and MCDA pregnancies. Results: The final dataset for analysis included a total of 9866 second‐ and third‐trimester ultrasound examinations in 1802 DCDA and 323 MCDA twin pregnancies, with a median of five (range, 1–14) scans per pregnancy. For each variable, the mean value for DCDA twins was close to the reported value in singletons at 20–30 weeks and showed a decrease relative to singletons beyond 30 weeks. The differences were greater for AC and HC, for which the mean in twins was approximately equivalent to the 30 th percentile in singletons at 18 weeks, the 35 th percentile at 25 weeks and the 30 th percentile at 35 weeks. Fetuses in MCDA twin pregnancies displayed lower mean measurements than did those in DCDA pregnancies throughout the gestational age range considered. Conclusions: Ultrasound biometry shows a small but statistically significant reduction in fetal growth in twin pregnancies relative to that in singletons, particularly in the third trimester, with a more marked difference for MCDA than for DCDA pregnancies. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.