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Perinatal Outcome of Monochorionic Twins With Selective IUGR Compared With Uncomplicated Monochorionic Twins

Published online by Cambridge University Press:  21 February 2012

Boaz Weisz*
Affiliation:
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel. boazmd@zahav.net.il
Liat Hogen
Affiliation:
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.
Yoav Yinon
Affiliation:
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.
Liat Gindes
Affiliation:
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.
Alon Shrim
Affiliation:
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.
Michal Simchen
Affiliation:
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.
Eyal Schiff
Affiliation:
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.
Shlomo Lipitz
Affiliation:
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.
*
*ADDRESS FOR CORRESPONDENCE: Dr Boaz Weisz, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel 52621.

Abstract

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Objective: To evaluate the perinatal outcome of MC twins with selective IUGR (sIUGR).

Study design: A prospective study, which included three groups of MC twins: Group A, uncomplicated MC twin pregnancies (n = 91); group B, sIUGR with normal umbilical artery Doppler (n = 19); and group C, sIUGR with abnormal (absence or reversed EDV) umbilical artery Doppler (n = 18). The latter were routinely hospitalized in the high-risk ward under strict surveillance.

Results: Neonatal outcome of fetuses complicated with sIUGR and normal Doppler was similar to controls. Neonates born to pregnancies complicated by sIUGR and abnormal Doppler had significantly increased incidence of CNS findings, RDS, NEC, sepsis, and neonatal death compared to controls. Adverse outcome in this group was independently associated only with gestational age at birth.

Conclusion: The perinatal outcomes of MC twins complicated with sIUGR and normal Doppler are similar to uncomplicated MC pregnancies. MC twins with sIUGR and abnormal Doppler have reasonable outcomes, yet significantly more neonatal complications compared to non-complicated MC twins.

Type
Articles
Copyright
Copyright © Cambridge University Press 2011