Cleary-Goldman and d'Alton discuss the implications of a new study in PLoS Medicine examining the risk of fetal death in uncomplicated monochorionic diamnotic twin pregnancies.
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http://dx.doi.org/10.1371/journal.pmed.0020180 | DOI Listing |
Am J Obstet Gynecol MFM
January 2025
Division of Neonatology, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands.
Background: Monochorionic (MC) twins share a single placenta which can be unequally shared, leading to selective fetal growth restriction (sFGR). Limited data is available on the prevalence and clinical consequences of proximate cord insertion (PCI) in sFGR pregnancies.
Objective: We aimed to investigate the prevalence of PCI in MC placentas with and without sFGR and per type of sFGR, and study the placental characteristics and perinatal outcome of PCI in sFGR pregnancies.
J Clin Med
December 2024
Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London SW17 0RE, UK.
Twin pregnancies account for 3% of all pregnancies and they are burdened by higher morbidity and mortality compared to singletons. The role of ultrasound in the screening, diagnosis and management of possible complications of twin pregnancies has been widely investigated in the current literature. However, despite the progress that have been made in the last decades regarding treatment and evidence-based management of complications, twin pregnancies remain at higher risk of adverse outcomes, requiring therefore dedicated surveillance.
View Article and Find Full Text PDFFetal Diagn Ther
November 2024
Department of Obstetrics and Gynecology, Ghent University Hospital, Ghent, Belgium.
J Am Coll Radiol
November 2024
Specialty Chair, New York University Medical Center, New York, New York.
The incidence of twin pregnancies has been rising, largely attributable to increasing use of artificial reproductive techniques. Ultrasound plays a critical role in establishing the chorionicity and amnionicity of multiple gestations, a key predictor of the expected risk and complications, along with guiding future clinical and imaging follow-up examinations and intervals. People carrying multiple gestations will typically undergo more ultrasound examinations (and occasionally fetal MRI) than those carrying singletons, at minimum including a first trimester dating scan, nuchal translucency scan at 11 to 14 weeks, an anatomy scan at 18 to 22 weeks, and other scans in the second and third trimesters for growth and surveillance.
View Article and Find Full Text PDFUltrasound Obstet Gynecol
December 2024
Center for Fetal Medicine, Pregnancy and Ultrasound, Department of Gynecology, Fertility and Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Objective: To assess the validity of the Fetal Medicine Foundation (FMF) chorionicity-specific models for fetal growth in twin pregnancy.
Methods: This was an external validation study of the FMF models using a nationwide Danish cohort of twin pregnancies. The cohort included all dichorionic (DC) and monochorionic diamniotic (MCDA) twin pregnancies with an estimated delivery date between 2008 and 2018, which satisfied the following inclusion criteria: two live fetuses at the first-trimester ultrasound scan (11-14 weeks' gestation); biometric measurements available for the calculation of estimated fetal weight (EFW) using the Hadlock-3 formula; and delivery of two liveborn infants.
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