Longitudinal Doppler references for monochorionic twins and comparison with singletons.
Adult
Blood Flow Velocity
/ physiology
Ductus Arteriosus
/ diagnostic imaging
Female
Gestational Age
Humans
Longitudinal Studies
Middle Cerebral Artery
/ diagnostic imaging
Pregnancy
Pregnancy, Twin
Pulsatile Flow
/ physiology
Reference Values
Retrospective Studies
Ultrasonography, Doppler
Umbilical Arteries
/ diagnostic imaging
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
06
08
2019
accepted:
19
11
2019
entrez:
7
12
2019
pubmed:
7
12
2019
medline:
27
3
2020
Statut:
epublish
Résumé
To construct monochorionic (MC) twin-specific longitudinal Doppler references for umbilical artery pulsatility index (UA-PI), middle cerebral artery (MCA) PI and peak systolic velocity (PSV) and ductus venosus (DV) PI derived from a strictly selected cohort of uncomplicated MC twins. The secondary aim of the study was to compare our findings with singleton reference charts. A retrospective evaluation was made of all consecutive uncomplicated MC twin pregnancies referred to our Unit from 2010 to 2018. Fortnightly serial examinations were performed of UA-PI, MCA-PI, MCA-PSV and DV-PI, according with the clinical protocol, from 20 to 37 weeks of gestation. We included cases with at least four ultrasound examinations, delivery at our hospital and complete neonatal follow up. A two-step method was used to trace the estimated centile curves: estimation of the median was performed with appropriate fractional polynomials by a multilevel model and estimation of the external centiles through the residuals (quantile regression). The comparison with singletons was made by plotting the references derived from the present study on the referred charts commonly used for singletons. The study group comprised 150 uncomplicated MC twin pairs. Estimated centiles (3rd, 5th, 10th, 50th, 90th, 95th, 97th) of UA-PI, MCA-PI, MCA-PSV and DV-PI in function of the gestational age are presented. The comparison with singletons showed substantial differences, with higher UA-PI and lower MCA-PI and PSV median values in MC twins. Median DV PI values were similar to the values for singletons, while the upper centiles were higher in MC twins. This study sets out MC twin-specific longitudinal references for UA-PI, MCA-PI, MCA-PSV and DV-PI derived from the largest series of uncomplicated MC twin pregnancies presently available. The comparison with singleton reference values underscores the deviation from physiology that is intrinsic to these unique pregnancies and supports the need for MC twin-specific charts.
Identifiants
pubmed: 31809530
doi: 10.1371/journal.pone.0226090
pii: PONE-D-19-19688
pmc: PMC6897428
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0226090Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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