| Nuchal translucency thickness and crown rump length discordance for the prediction of outcome in monochorionic diamniotic pregnancies. | |
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MedLine Citation:
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PMID: 20961716 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Ultrasonographic features of the underlying hemodynamic changes in twin-twin transfusion syndrome (TTTS) may be present at the first trimester scan. AIMS: To investigate the value of intertwin discordance in nuchal translucency (NT) thickness and crown-rump length (CRL) to predict TTTS and other adverse outcomes. STUDY DESIGN: Cohort study. SUBJECTS: One hundred and thirty-five unselected consecutive monochorionic diamniotic twin pregnancies. OUTCOME MEASURES: NT and CRL discordance were assessed at 11 to 13(+6) weeks' gestation. Receiver-operating characteristics (ROC) curves were used to determine their predictive ability for the subsequent development of TTTS. RESULTS: TTTS complicated 16/135 (12%) pregnancies. Four other pregnancies were complicated by selective intrauterine growth restriction (sIUGR) and 3 by miscarriage <24 weeks gestation. The median NT discordance was 15% (range 0-37%) in TTTS pregnancies, 13% (12-19%) in those with miscarriage <24 weeks' gestation, 47% (30-50%) in those with sIUGR, and 14% (0-86%) in those without complications. Prediction for subsequent development of TTTS provided by the discordance in CRL, expressed as the area under ROC curve, was 0.52 (95% confidence interval 0.38-0.67), while it was 0.50 for NT discordance (95% confidence interval 0.35-0.64). NT discordance was significantly higher in sIUGR compared to both uncomplicated and TTTS pregnancies (p=0.004 and p=0.003, respectively). CONCLUSION: In an unselected population of monochorionic twin pregnancies, discordance in CRL and NT measured during first trimester scan is not a clinically useful predictor of the subsequent development of TTTS. Therefore, strict ultrasound follow up is recommended for the timely diagnosis of TTTS. |
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Authors:
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Nicola Fratelli; Federico Prefumo; Anna Fichera; Adriana Valcamonico; Daria Marella; Tiziana Frusca |
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Publication Detail:
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Type: Journal Article Date: 2010-10-20 |
Journal Detail:
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Title: Early human development Volume: 87 ISSN: 1872-6232 ISO Abbreviation: Early Hum. Dev. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7708381 Medline TA: Early Hum Dev Country: Ireland |
Other Details:
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Languages: eng Pagination: 27-30 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Ltd. All rights reserved. |
Affiliation:
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Maternal Fetal Medicine Unit, Department of Obstetrics and Gynaecology, University of Brescia, Piazzale Spedali Civili 1, Brescia, Italy. nicolaf23@gmail.com |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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