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Esophageal atresia in twins compared to singletons: In utero manifestation and characteristics
Author(s) -
Weissbach Tal,
Kassif Eran,
Kushnir Anya,
ShustBarequet Shir,
Leibovitch Leah,
Eliasi Elior,
ElkanMiller Tal,
Zajicek Michal,
Yi Yoav,
Weisz Boaz
Publication year - 2020
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5785
Subject(s) - polyhydramnios , atresia , medicine , tracheoesophageal fistula , pouch , in utero , obstetrics , duodenal atresia , twin pregnancy , fetus , pregnancy , gynecology , surgery , biology , genetics
Objective Esophageal atresia with/without tracheo‐esophageal fistula (EA/TEF) is more common among twins. The detection of polyhydramnios might be altered in twins, leading to EA/TEF underdiagnosis, prenatally. The aim of the study was to compare the prenatal manifestation of EA/TEF between twins and singletons. Methods A 12‐year study of EA/TEF cases was performed at a tertiary center. Cases exhibiting (a) small/absent stomach or (b) polyhydramnios were considered “suspected” ; cases with (c) esophageal pouch were considered “detected . ” We compared the rate and timing of appearance of these signs between the groups. Results There were 76 cases of EA/TEF, of which 17 were a co‐twin. All twin pairs were EA/TEF discordant. The prevalence of EA/TEF at our center was 1:750 for twins (1:319 monochorionic and 1:1133 dichorionic) and 1:2399 for singletons. The rate of small/absent stomach, polyhydramnios and pouch in twins vs singletons was 23.5%, 47.1%, 29.4% and 39.7%, 72.4%,34.5%, respectively ( P = .2, P = .09 and P = .7). Esophageal pouch was detected earlier in twins ( P = .03 ). Twins were scanned more frequently (×1.8 times, P = .01 ). Conclusion EA/TEF is more prevalent in twins. Despite lower rate of polyhydramnios, twins were similarly detected prenatally as singletons, and this was accomplished earlier in pregnancy; perhaps reflecting more frequent scans.