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Perinatal complications of monochorionic diamniotic twin gestations with discordant crown–rump length determined at mid‐first trimester
Author(s) -
Nakayama Soichiro,
Ishii Keisuke,
Kawaguchi Haruna,
Yamamoto Ryo,
Murata Masaharu,
Hayashi Shusaku,
Mitsuda Nobuaki
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12178
Subject(s) - medicine , obstetrics , monochorionic twins , gestation , crown rump length , anemia , fetus , pregnancy , retrospective cohort study , twin pregnancy , first trimester , surgery , biology , genetics
Aim The aim of this study was to investigate the value of discordance of crown–rump length ( DCRL ) at mid‐first trimester to predict adverse outcomes in monochorionic diamniotic twin gestations ( MD ). Material and Methods This was a retrospective cohort study of the perinatal outcome in MD pregnancies managed from the first trimester onward. DCRL was evaluated between 8 and 10 weeks of gestation. The association between DCRL and perinatal complications, including fetal death, twin–twin transfusion syndrome, severe discordant birthweight ( DB ), and twin anemia‐polycythemia sequence, was assessed. Results Among 126 cases, a single fetal demise occurred in two (2%) and demise of both fetuses occurred in eight (6%). Five pregnancies (4%) were complicated with twin–twin transfusion syndrome; one case (1%) was twin anemia‐polycythemia sequence and 13 (10%) were DB . Neonatal death occurred in one pair. At 28 days of age, in 115 cases (91%) both twins were alive. In 117 cases (93%), at least one twin survived until 28 days of age. DCRL >12.0% was not related to any perinatal complications but DB ( P < 0.01; relative risk: 1.40; 95% confidence interval: 1.06–1.84). Conclusions DCRL in MD during the mid‐first trimester might be useful for predicting DB .