Document Detail


Prediction of selective fetal growth restriction and twin-to-twin transfusion syndrome in monochorionic twins.
MedLine Citation:
PMID:  22324917     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Please cite this paper as: Memmo A, Dias T, Mahsud-Dornan S, Papageorghiou A, Bhide A, Thilaganathan B. Prediction of selective fetal growth restriction and twin-to-twin transfusion syndrome in monochorionic twins. BJOG 2012;119:417-421. Objective  To study the correlation of discrepancy between crown-rump length (CRL) and nuchal translucency (NT) in monochorionic twins at 11-14 weeks of gestation and subsequent development of twin-to-twin transfusion syndrome (TTTS) and selective fetal growth restriction (sFGR). Design  Retrospective cohort study. Setting  Tertiary-care Fetal Medicine Unit, London. Sample  Monochorionic twin pregnancies with known outcome. Methods  Inter-twin discrepancy was calculated as a percentage of the larger CRL and smaller NT and compared among those developing TTTS, those with sFGR and those with normal outcome. Receiver operating characteristic (ROC) curves were constructed to evaluate the performance of inter-twin discrepancy in prediction of sFGR and TTTS. Main outcome measures  Development of TTTS and sFGR. Results  A total of 242 monochorionic twin pregnancies were studied (102 TTTS, 36 sFGR and 104 controls). The median CRL discrepancy in the sFGR group (11.9%) was significantly higher (P < 0.001) than in the TTTS group (3.8%) and control group (3.5%). Median inter-twin NT discrepancies were not significantly different (P = 0.869) between sFGR and both TTTS and control groups (15.6%, 16.7% and 14.8%, respectively). Discrepancy in CRL performs well as a screening test for sFGR (area under ROC curve = 0.89), but not for TTTS (area under ROC curve = 0.58). Conclusions  First-trimester CRL discrepancy in monochorionic twins is a marker for subsequent development of sFGR rather than TTTS. Inter-twin NT discrepancy does not appear to be significantly different in these two groups from those with normal outcome.
Authors:
A Memmo; T Dias; S Mahsud-Dornan; At Papageorghiou; A Bhide; B Thilaganathan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  119     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  417-21     Citation Subset:  AIM; IM    
Copyright Information:
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.
Affiliation:
Fetal Medicine Unit, St George's University of London, London, UK.
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