Document Detail

Gestational age specific reference ranges for amniotic fluid assessment in monochorionic diamniotic twin pregnancies.
MedLine Citation:
PMID:  23292907     Owner:  NLM     Status:  Publisher    
OBJECTIVES: The aim of this study was to establish gestational age-specific reference ranges for amniotic fluid measurements in monochorionic diamniotic twin pregnancies, to compare them with previously reported singleton and twin reference ranges, and to examine the rationale for a gestational age dependent cut-off to define the polyhydramnios in twin-twin transfusion syndrome, such as is practiced by most European centers. METHODS: We retrospectively evaluated the amniotic fluid quantity in 32 monochorionic diamniotic twin pregnancies that were followed longitudinally at 2-weekly intervals from the first trimester until birth. Amniotic fluid volume was assessed measuring the deepest vertical pocket in both amniotic sacs. We used multilevel modeling to estimate the gestational age-specific reference ranges for deepest vertical pocket measurements. RESULTS: Based on 429 observations in 64 fetuses, we constructed gestational age-specific reference ranges from 11 weeks until term. The deepest pocket increased from the first trimester to reach a maximum at 26 weeks, followed by a gradual decrease toward term. Measurements between 18 and 28 weeks were comparable to those in singletons. However, before 18 weeks, values were higher whereas after 28 weeks, they were lower compared to singleton references. CONCLUSIONS: In monochorionic twin pregnancies, the deepest vertical pocket is a gestational age dependent measurement. Therefore, a gestational dependent definition of the polyhydramnios in twin-twin transfusion syndrome, such as is used by most European centers, seems a logic approach.
P Dekoninck; J Deprest; P Lewi; J Richter; S Galjaard; J Van Keirsbilck; K Van Calsteren; L Lewi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-4
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd.
Fetal Medicine Unit, Department of Obstetrics and Gynecology, University Hospitals Leuven & Research Unit Fetus, Placenta and Neonate, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
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