Selective IUGR in dichorionic twins: what can Doppler assessment and growth discordancy say about neonatal outcomes?
| Autor: | Petya Vitanova Petrova, Nadia Roncaglia, Sabrina Cozzolino, Salvatore Andrea Mastrolia, Matteo Frigerio, Patrizia Vergani, Maria Lamanna, Paola Algeri, Maddalena Incerti |
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| Přispěvatelé: | Algeri, P, Frigerio, M, Lamanna, M, Petrova, P, Cozzolino, S, Incerti, M, Mastrolia, S, Roncaglia, N, Vergani, P |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Neonatal intensive care unit Population Intrauterine growth restriction Risk Assessment growth restriction Ultrasonography Prenatal Umbilical Arteries 03 medical and health sciences 0302 clinical medicine Obstetrics and gynaecology Pregnancy Risk Factors Twins Dizygotic Medicine Birth Weight Humans 030212 general & internal medicine Risk factor education Twin Pregnancy Retrospective Studies education.field_of_study 030219 obstetrics & reproductive medicine Fetal Growth Retardation business.industry Obstetrics Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Retrospective cohort study Ultrasonography Doppler twin pregnancy medicine.disease Prognosis inter-twin difference Italy Pediatrics Perinatology and Child Health Pregnancy Twin Premature Birth Female pregnancy complication business Doppler velocimetry Neonatal resuscitation |
| Zdroj: | Journal of perinatal medicine. 46(9) |
| ISSN: | 1619-3997 |
| Popis: | Objective: The aim of the present study was to assess, in a population of dichorionic twin pregnancies with selective growth restriction, the effect of inter-twin differences by use of Doppler velocimetry and fetal growth discordancy on perinatal outcomes. Methods: This was a retrospective study including dichorionic twin pregnancies from January 2008 to December 2015 at the Department of Obstetrics and Gynecology of Fondazione MBBM. Only dichorionic twin pregnancies affected by selective intrauterine growth restriction (IUGR) delivering at ≥24 weeks were included in the study. Results: We found that twin pregnancies with inter-twin estimated fetal weight (EFW) discordance ≥15% were significantly associated with a higher risk of preterm delivery before 32 (P=0.004) and 34 weeks (P=0.04). Similarly, twin pregnancies with inter-twin abdominal circumference (AC) discordance ≥30° centiles were associated with a higher rate of neonatal intensive care unit (NICU) admission (P=0.02), neonatal resuscitation (P=0.02) and adverse neonatal composite outcome (P=0.04). Of interest, when comparing twin pregnancies according to Doppler study, growth restricted twins had a higher rate of composite neonatal outcome and in multivariate analysis, an abnormal Doppler was an independent risk factor for this outcome. Conclusions: Our study associated growth discrepancy with specific pregnancy outcomes, according to defined cut-offs. In addition, we demonstrated that an abnormal umbilical artery Doppler is independently associated with a composite neonatal adverse outcome in growth restricted fetuses. |
| Databáze: | OpenAIRE |
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