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WS13‐04Doppler velocimetry determined brain sparing effect: correlations with neonatal outcome in diamniotic monochorionic and diamniotic dichorionic twins
Author(s) -
Gaziano E. P.,
Gaziano C.,
Hoesktra R.,
Terrell C.
Publication year - 2000
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 - 10.1046/j.1469-0705.2000.00009-1-80.x
Subject(s) - medicine , obstetrics , umbilical artery , fetus , pregnancy , biology , genetics
Objective Neonatal outcome was studied in 169 infants from diamniotic monochorionic (DAMC) and diamniotic dichorionic (DADC) twin pregnancies in relation to a measure of blood flow redistribution, the cerebroplacental ratio (CPR). Study design Two groups were assessed, 50 infants from DAMC, and 119 infants from DADC twin pregnancies. Targeted ultrasound and Doppler recordings of umbilical artery (UA) and middle cerebral artery (MCA) were obtained. The resistance index (RI) and CPR were calculated for each fetus. Results DAMC twins had lower birth weight (1979 vs. 2223 g for DADC, p≤.01) and prolonged lengths of nicu stay (8.5 days vs. 3.5 days for DADC, p≤.05). For total group, DAMC compared with DADC twins spent greater numbers of days on a ventilator. SGA infants were significantly more frequent in DAMC twins compared to DADC twins. Among antenatal Doppler variables only the CPR demonstrated a significant difference between twin types. For DAMC twins CPR was 1.15 vs. 1.21 for DADC twins, p≤.05. Conclusions Monochorionic twins from the lower birth weight groups demonstrate a greater number of growth restricted infants and prolonged hospitalizations compared to DADC twins. Among Doppler measures, the CPR is superior to UA‐RI, and/or MCA‐RI for the prediction of adverse events.