Document Detail

Nuchal translucency thickness and crown rump length discordance for the prediction of outcome in monochorionic diamniotic pregnancies.
MedLine Citation:
PMID:  20961716     Owner:  NLM     Status:  In-Process    
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.
Nicola Fratelli; Federico Prefumo; Anna Fichera; Adriana Valcamonico; Daria Marella; Tiziana Frusca
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Publication Detail:
Type:  Journal Article     Date:  2010-10-20
Journal Detail:
Title:  Early human development     Volume:  87     ISSN:  1872-6232     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  27-30     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ltd. All rights reserved.
Maternal Fetal Medicine Unit, Department of Obstetrics and Gynaecology, University of Brescia, Piazzale Spedali Civili 1, Brescia, Italy.
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