Vascular anastomoses in intrauterine growth in monochorionic twins.
Adult
Arteriovenous Anastomosis
/ physiopathology
Birth Weight
Cesarean Section
/ statistics & numerical data
Chorion
Delivery, Obstetric
Female
Fetal Development
/ physiology
Gestational Age
Humans
Infant, Newborn
Placenta
/ blood supply
Pregnancy
Pregnancy, Twin
Premature Birth
/ epidemiology
Prospective Studies
Reproductive Techniques, Assisted
/ statistics & numerical data
intrauterine growth
monochorionic twins
twin gestation
vascular anastomoses
Journal
Journal of perinatal medicine
ISSN: 1619-3997
Titre abrégé: J Perinat Med
Pays: Germany
ID NLM: 0361031
Informations de publication
Date de publication:
28 Jul 2020
28 Jul 2020
Historique:
received:
22
01
2020
accepted:
23
03
2020
pubmed:
19
4
2020
medline:
11
6
2021
entrez:
19
4
2020
Statut:
ppublish
Résumé
Objectives To evaluate the impact of placental anastomoses on the intrauterine growth of monochorionic (MC) twins. Methods A prospective study was conducted in a group of 53 MC twins. Intrapartally umbilical cords were clamped to identify placental sides corresponding to each twin. The postnatal dye injection technique was administered to evaluate vascular anastomoses, their number and type and visualize placental territory sharing patterns. Data from digital analysis were correlated with obstetrical follow-up. Results Vascular anastomoses were revealed in 88.7% of cases. Arteriovenous (AV) anastomoses occurred in 75.4% and arterioarterial (AA) in 71.1% while venovenous (VV) in 26.4%. In the subgroup of MC twins without placental anastomoses, significantly higher birthweight difference and discordance were revealed when compared to MC twins without anastomoses (382.0 vs. 22 g; P = 0.03 and 49.14% vs. 16.02%; P = 0.03). On the other hand, in subgroups of MC twins with at least one AA anastomosis, twins' birthweights were similar (p = ns) despite significantly higher placental territory sharing discordance (30.44% vs. 15.81%; P = 0.31). Conclusions Vascular anastomoses have a major impact on the intrauterine growth of MC twins. In certain cases, they may cause specific complications; however, in general, they regulate intertwin blood exchange and may compensate unequal placental territory.
Identifiants
pubmed: 32304312
doi: 10.1515/jpm-2020-0028
pii: jpm-2020-0028
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
539-543Références
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