Outcome of monochorionic diamniotic twin pregnancy with selective intrauterine growth restriction, a single center study in China

Tian Qiu; Yuna Guo; Weiwei Cheng; Yan Chen; Hong Shen; Liang Xu

doi:10.1016/j.clinimag.2023.110032

Outcome of monochorionic diamniotic twin pregnancy with selective intrauterine growth restriction, a single center study in China

Clin Imaging. 2024 Feb:106:110032. doi: 10.1016/j.clinimag.2023.110032. Epub 2023 Nov 23.

Authors

Tian Qiu¹, Yuna Guo², Weiwei Cheng², Yan Chen², Hong Shen², Liang Xu³

Affiliations

¹ Department of Obstetrics and Gynecology, The Sixth People's Hospital of Shanghai Affiliated to Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, China.
² Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital Affiliated to Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai 200030, China.
³ Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital Affiliated to Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai 200030, China. Electronic address: liangxu73@edtedu.cn.

PMID: 38042047
DOI: 10.1016/j.clinimag.2023.110032

Abstract

Introduction: This retrospective study aimed to evaluate clinical outcomes of monochorionic diamniotic (MCDA) twins with selective intrauterine growth restriction (sIUGR).

Materials and methods: MCDA twins, either sIUGR and non-sIUGR, underwent expectant management from 2016 to 2019 in our hospital were included. sIUGR fetuses were classified into three types according to umbilical artery Doppler assessment. Non-sIUGR were considered as the control group. Outcomes were pregnancy outcomes and maternal complications.

Results: Forty-three sIUGR (type I: 23; type II: 14, and type III: 6) and 282 non-sIUGR fetuses were included. The sIUGR group had a significantly earlier birth, lower birth weight of the twins, larger inter-twin weight difference, lower Apgar score of the twins, and higher intrauterine fetal death (IUFD) than the non-sIUGR group (all p < 0.001). The same trend was found in the sIUGR type II group compared to type I and III groups. A significantly lower gestational diabetes rate (p = 0.01) and placenta weight (p < 0.001), and higher proportions of abnormal placental umbilical cord insertion (p < 0.001), and ultrasound Doppler monitoring indicators (p = 0.006) were found in the sIUGR group than the non-sIUGR group.

Conclusions: The MCDA twins with sIUGR showed poorer outcomes than the non-sIUGR group. Doppler interrogation was a useful clinical marker for fetal outcome.

Keywords: Doppler ultrasound waveforms; Intrauterine fetal demise; Monochorionic diamniotic; Selective intrauterine growth restriction.

MeSH terms

Female
Fetal Growth Retardation* / diagnostic imaging
Fetal Growth Retardation* / epidemiology
Humans
Placenta
Pregnancy
Pregnancy, Twin*
Retrospective Studies
Twins, Monozygotic
Ultrasonography, Prenatal