Document Detail


The cerebroplacental Doppler ratio and neonatal outcome in diamnionic monochorionic and dichorionic twins.
MedLine Citation:
PMID:  11798445     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Neonatal outcome in twins was studied in relation to the cerebroplacental ratio (CPR). METHODS: Seventy-five infants from twin pregnancies with fetal Doppler data obtained within 3 weeks of delivery were candidates for study (23 infants from diamnionic monochorionic and 52 infants from diamnionic dichorionic twin pregnancies). Multivariate regression analyses were expanded to include 114 twin infants (34 diamnionic monochorionic and 80 diamnionic dichorionic twins). Patients with twin transfusion syndrome were excluded from analysis in the monochorionic group. Targeted ultrasound examination with biometry was performed, and Doppler resistance index (RI) of the umbilical artery (UA) and the middle cerebral artery (MCA) were obtained, and the CPR, a measure of blood flow redistribution, was calculated. Outcome variables included major complications, growth restriction, days of ventilator and oxygen use, days in the neonatal intensive care unit and length of stay. RESULTS: The CPR was correlated more highly with adverse outcomes such as birth weight, special-care nursery days and length of stay than were the UA RI or the MCA RI. The CPR was significantly lower in monochorionic compared with dichorionic twins (1.12 vs. 1.27, p = 0.01). Multivariate regression analyses conducted separately on each twin group also demonstrated that CPR was superior to UA RI and MCA RI in predicting length of stay and restricted growth. Among the Doppler variables, the CPR showed the highest sensitivity for growth restriction (67%). CONCLUSION: In twins, CPR was superior to UA RI and MCA RI in predicting adverse neonatal events.
Authors:
E P Gaziano; C Gaziano; C A Terrell; R E Hoekstra
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of maternal-fetal medicine     Volume:  10     ISSN:  1057-0802     ISO Abbreviation:  J Matern Fetal Med     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2002-01-18     Completed Date:  2002-03-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9211288     Medline TA:  J Matern Fetal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  371-5     Citation Subset:  IM    
Affiliation:
Perinatal Center, Abbott Northwestern Hospital, Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, Minnesota 55407, USA. mannysr@pol.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Cerebral Arteries / embryology*,  physiology*
Chorion
Female
Fetal Growth Retardation / diagnosis*
Fetus / blood supply*
Humans
Infant, Newborn
Intensive Care Units, Neonatal
Laser-Doppler Flowmetry / standards
Length of Stay*
Minnesota
Multivariate Analysis
Predictive Value of Tests
Pregnancy
Pregnancy Outcome
Pregnancy, Multiple / physiology*
Prenatal Diagnosis / standards
Pulsatile Flow
Regional Blood Flow
Retrospective Studies
Sensitivity and Specificity
Twins, Dizygotic
Twins, Monozygotic
Umbilical Arteries / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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