Document Detail

Early pregnancy growth and pregnancy outcome in twin pregnancies.
MedLine Citation:
PMID:  21033303     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The objective of this study was to determine the association of crown-rump length (CRL) discrepancy in monochorionic and dichorionic twins with subsequent pregnancy outcomes.
METHOD: A retrospective analytical study was performed among 660 twin pregnancies over 12 years in one fetal medicine tertiary referral center in the United Kingdom. A literature search was performed to identify all reports in the English language literature in this topic between 1998 and 2009.
RESULTS: Five hundred and six dichorionic and 154 monochorionic twin pregnancies were studied. Median percentage CRL discordance in monochorionic and dichorionic pregnancies was not different (3.9 +/- 8.34, range 0-59 and 3.2 +/- 5.65 range 0-37.5, respectively, p = 0.225). Single or double fetal loss was higher in monochorionic twins than the dichorionic twins. Loss rate was 17.53% (27) and 3.95% (20) respectively (p = < .0001). CRL disparity and birth weight discordancy showed statistically significant correlation (Spearman's rho, p = 0.040). Statistically significant correlation was seen between percentage CRL disparity and pregnancy loss rate (p = 0.008). However, the sensitivity of this CRL discrepancy to detect subsequent fetal loss or birth weight discordance is poor.
INTERPRETATION: CRL discrepancy is independent of chorionicity in twins. CRL discrepancy is correlated to subsequent pregnancy loss and birth weight discordance, but the clinical utility of this observation is limited. The difference in twin CRL at 11-14 weeks is likely to represent physiological variation in a majority of cases.
T Dias; A Bhide; B Thilaganathan
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Ceylon medical journal     Volume:  55     ISSN:  0009-0875     ISO Abbreviation:  Ceylon Med J     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-10-29     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1264702     Medline TA:  Ceylon Med J     Country:  Sri Lanka    
Other Details:
Languages:  eng     Pagination:  80-4     Citation Subset:  IM    
Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's University of London, UK.
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MeSH Terms
Chi-Square Distribution
Crown-Rump Length*
Fetal Death
Fetal Growth Retardation / epidemiology
Great Britain / epidemiology
Pregnancy Outcome*
Pregnancy, Multiple*
ROC Curve
Retrospective Studies
Statistics, Nonparametric
Twins / physiology*

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