Intrauterine growth restriction in monochorionic-diamniotic twins.

Autor:	Machado Rde C; Department of Obstetric, Hospital das Clínicas, University of São Paulo's Medical School, São Paulo, SP, Brazil., Brizot Mde L; Department of Obstetric, Hospital das Clínicas, University of São Paulo's Medical School, São Paulo, SP, Brazil., Miyadahira S; Department of Obstetric, Hospital das Clínicas, University of São Paulo's Medical School, São Paulo, SP, Brazil., Francisco RP; Department of Obstetric, Hospital das Clínicas, University of São Paulo's Medical School, São Paulo, SP, Brazil., Krebs VL; Department of Pediatrics, Hospital das Clínicas, University of São Paulo's Medical School, São Paulo, SP, Brazil., Zugaib M; Department of Obstetric, Hospital das Clínicas, University of São Paulo's Medical School, São Paulo, SP, Brazil.
Jazyk:	angličtina
Zdroj:	Revista da Associacao Medica Brasileira (1992) [Rev Assoc Med Bras (1992)] 2014 Nov-Dec; Vol. 60 (6), pp. 585-90.
DOI:	10.1590/1806-9282.60.06.019
Abstrakt:	Objective: to evaluate neonatal morbidity and mortality in monochorionic-diamniotic (MCDA) twin pregnancies complicated by selective intrauterine growth restriction (sIUGR) and non-selective intrauterine growth resctriction (nsIUGR). Methods: neonatal morbidity parameters and mortality were analyzed in 34 twins with IUGR (< 10th percentile on twins' growth charts): 18 with sIUGR and 16 with nsIUGR. The sIUGR group was made up of 18 pregnancies in which growth was restricted in only one fetus (n = 18). The nsIUGR group was composed of 8 pregnancies in which both fetuses presented restricted growth (n = 16). Cases of twin-to-twin transfusion syndrome and fetal malformation were not included in the study. Results: the MCDA twin pregnancies with sIUGR had a higher rate of orotracheal intubation (p = 0.001) and mechanical ventilation (p = 0.0006), as well as longer than average fasting time (p = 0.014) compared to those in which the fetuses had nsIUGR. A higher incidence was also observed of types II and III umbilical artery Doppler velocimetry patterns in the sIUGR cases (p = 0.002). There was no significant difference between the two groups as to mortality during pregnancy and the neonatal period (p = 0.09). Conclusion: in MCDA twin pregnancies, sIUGR presents more severe umbilical artery Doppler velocimetry abnormalities and worse morbidity than nsIUGR.
Databáze:	MEDLINE
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