Prediction of fetal death in monochorionic twin pregnancies complicated by Type-III selective fetal growth restriction.
fetal growth restriction
fetal monitoring
fetal wellbeing
multiple pregnancy
prediction
twins
Journal
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN: 1469-0705
Titre abrégé: Ultrasound Obstet Gynecol
Pays: England
ID NLM: 9108340
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
revised:
02
02
2022
received:
31
12
2021
accepted:
15
02
2022
pubmed:
9
3
2022
medline:
3
6
2022
entrez:
8
3
2022
Statut:
ppublish
Résumé
Monochorionic diamniotic twin pregnancies complicated by Type-III selective fetal growth restriction (sFGR) are at high risk of fetal death. The aim of this study was to identify predictors of fetal death in these pregnancies. This was an international multicenter retrospective cohort study. Type-III sFGR was defined as fetal estimated fetal weight (EFW) of one twin below the 10 A total of 308 twin pregnancies (616 fetuses) were included in the analysis. In 273 (88.6%) pregnancies, both twins were liveborn, whereas 35 pregnancies had single (n = 19 (6.2%)) or double (n = 16 (5.2%)) fetal death. On univariable analysis, earlier gestational age at diagnosis of Type-III sFGR, oligohydramnios in the smaller twin and deterioration in umbilical artery Doppler flow were associated with an increased risk of fetal death, as was larger fetal EFW discordance, particularly between 24 and 32 weeks' gestation. None of the parameters identified on univariable analysis maintained statistical significance on multivariable analysis. The CART model allowed us to identify three risk groups: a low-risk group (6.8% risk of fetal death), in which umbilical artery Doppler did not deteriorate; an intermediate-risk group (16.3% risk of fetal death), in which umbilical artery Doppler deteriorated but the diagnosis of sFGR was made at or after 16 + 5 weeks' gestation; and a high-risk group (58.3% risk of fetal death), in which umbilical artery Doppler deteriorated and gestational age at diagnosis was < 16 + 5 weeks' gestation. Type-III sFGR is associated with a high risk of fetal death. A prediction algorithm can help to identify the highest-risk group, which is characterized by Doppler deterioration and early referral. Further studies should investigate the potential benefit of fetal surveillance and intervention in this cohort. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
756-762Investigateurs
Yidi Jiang
(Y)
Wei Xing
(W)
Chen Jianping
(C)
Isabel Couck
(I)
Sophie Groene
(S)
Linoy Batsry
(L)
Sofia Amylidi-Mohr
(S)
Fannie Kneuss
(F)
Joske Moscou
(J)
Jon Barrett
(J)
Vagisha Pruthi
(V)
Greg Ryan
(G)
Informations de copyright
© 2022 International Society of Ultrasound in Obstetrics and Gynecology.
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