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Diagnostic accuracy of ultrasound in predicting birth‐weight discordance in twin pregnancy: systematic review and meta‐analysis
Author(s) -
Leombroni M.,
Liberati M.,
Fanfani F.,
Pagani G.,
Familiari A.,
Buca D.,
Manzoli L.,
Scambia G.,
Rizzo G.,
D'Antonio F.
Publication year - 2017
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.17348
Subject(s) - medicine , obstetrics , diagnostic odds ratio , ultrasound , birth weight , twin pregnancy , receiver operating characteristic , odds ratio , likelihood ratios in diagnostic testing , positive predicative value , meta analysis , pregnancy , gynecology , predictive value , gestation , radiology , genetics , biology
Objective To investigate the diagnostic performance of ultrasound in predicting birth‐weight ( BW ) discordance in twin pregnancy. Methods Electronic databases PubMed, EMBASE and CINAHL were searched using combinations of MeSH terms ‘birth weight’, ‘discordance’, ‘twins’ and ‘ultrasound’. Summary estimates of sensitivity, specificity, positive and negative likelihood ratios and diagnostic odds ratios for the predictive accuracy of sonographically estimated fetal‐weight ( EFW ) discordance and abdominal‐circumference ( AC ) discordance in predicting BW discordance were computed using hierarchical summary receiver–operating characteristics curves. Results Twenty studies (including 5826 twin pregnancies) were included. EFW discordance ≥ 20% had a sensitivity of 65.4% and specificity of 90.8% in predicting BW discordance ≥ 20%. The predictive performance of ultrasound performed within 1 month, 2 weeks and 3 days before birth was 61.4%, 72.3% and 78.9%, respectively. EFW discordance ≥ 25% had a sensitivity of 57.7% and specificity of 95.2% in predicting BW discordance ≥ 25%. The sensitivity of EFW discordance ≥ 25% detected within 1 month, 2 weeks and 3 days before birth was 60.0%, 75.0% and 60.3%, respectively, while the corresponding values for specificity were 97.7%, 96.2% and 87.3%, respectively. In view of the different cut‐offs reported among studies, it was not possible to perform comprehensive data synthesis for each AC discordance cut‐off. The optimal diagnostic performance of AC discordance was for prediction of BW discordance ≥ 25%, with a sensitivity of 70.8% and specificity of 86.4%. Conclusion Ultrasound EFW discordance has an overall moderate accuracy in predicting BW discordance in twin pregnancy. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.