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P343: Longer latency of AEDF in monochorionic twins
Author(s) -
Fichera A.,
Vanderheyden T.,
Pasquini L.,
Tan T.,
Wee L. Y.,
Frusca T.,
Fisk N. M.
Publication year - 2003
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.812
Subject(s) - medicine , gestational age , monochorionic twins , singleton , latency (audio) , obstetrics , cohort , fetus , gestation , pregnancy , genetics , electrical engineering , biology , engineering
Objective: To validate the clinical impression that absent enddiastolicflow (AEDF) in the umbilical artery (UA) in monochorionic(MC) has a longer latency compared to singleton or dichorionic(DC) twin pregnancies with AEDF.Methods: All patients with AEDF in the UA were identified by searchof the patient databases in 2 fetal medicine centres. After excluding21 pregnancies due to incomplete data (n = 18), and structural orchromosomal anomalies (n = 3), a total of 53 MC pregnancies werecompared with two cohort groups – singleton pregnancies (n = 74)and dichorionic twins (n = 19). Latency was defined as days fromdiagnosis of AEDF till delivery or intrauterine death.Results: A total of 146 pregnancies with AEDF were analysed,including 25 MC twins with IUGR (17%) and 28 with TTTS(19%). Median latency was 43 days (7–153) in the MC group,30 days (1–66) in the DC group and 10 days (range 0–68) inthe singletons. MC twins had significantly longer latency than thesingletons (p = 0.007), but there was no significant difference withthe DCDA. After excluding the TTTS group, non-TTTS MC twinshad a significantly longer latency than DC twins. The overall mediangestational age at onset of AEDF [176 days (range: 108–253)]was significantly earlier in MC twins (median 147 days) than inDC (190 days) or singleton (189.50 days) pregnancies (p < 0.001).Latency was linearly correlated with gestational age at onset ofAEDF (R2 = 0.564).Conclusion: The latency of AEDF is longer in MC twins,suggesting a different patho-physiological mechanism then simpledownstream resistance