American Journal of Obstetrics & Gynecology
Volume 199, Issue 5 , Pages 511.e1-511.e7 , November 2008

Clinical outcome and placental characteristics of monochorionic diamniotic twin pairs with early- and late-onset discordant growth

Presented at the 28th Annual Meeting of the Society for Maternal-Fetal Medicine, Dallas, TX, Jan. 28-Feb. 2, 2008.

  • Liesbeth Lewi, MD

      Affiliations

    • Departments of Obstetrics and Gynecology and Radiology, University Hospitals, Leuven, Belgium
    • ,
  • Leonardo Gucciardo, MD

      Affiliations

    • Departments of Obstetrics and Gynecology and Radiology, University Hospitals, Leuven, Belgium
    • ,
  • Agnes Huber, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Universitätsklinikum Hamburg-Eppendorf, Germany
    • ,
  • Jacques Jani, MD, PhD

      Affiliations

    • Departments of Obstetrics and Gynecology and Radiology, University Hospitals, Leuven, Belgium
    • ,
  • Tim Van Mieghem, MD

      Affiliations

    • Departments of Obstetrics and Gynecology and Radiology, University Hospitals, Leuven, Belgium
    • ,
  • Elisa Doné, MD

      Affiliations

    • Departments of Obstetrics and Gynecology and Radiology, University Hospitals, Leuven, Belgium
    • ,
  • Mieke Cannie, MD

      Affiliations

    • Departments of Obstetrics and Gynecology and Radiology, University Hospitals, Leuven, Belgium
    • ,
  • Eduardo Gratacós, MD, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
    • ,
  • Anke Diemert, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Universitätsklinikum Hamburg-Eppendorf, Germany
    • ,
  • Kurt Hecher, MD, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, Universitätsklinikum Hamburg-Eppendorf, Germany
    • ,
  • Paul Lewi, PhD, Eng

      Affiliations

    • Departments of Obstetrics and Gynecology and Radiology, University Hospitals, Leuven, Belgium
    • ,
  • Jan Deprest, MD, PhD

      Affiliations

    • Departments of Obstetrics and Gynecology and Radiology, University Hospitals, Leuven, Belgium

Received 17 October 2007 ,Revised 27 January 2008 ,Accepted 10 April 2008.

References 

  1. Sebire NJ, Snijders RJ, Hughes K, Sepulveda W, Nicolaides KH. The hidden mortality of monochorionic twin pregnancies. Br J Obstet Gynaecol. 1997;104:1203–1207
  2. Acosta-Rojas R, Becker J, Munoz-Abellana B, et al. Twin chorionicity and the risk of adverse perinatal outcome. Int J Gynaecol Obstet. 2007;96:98–102
  3. Gratacós E, Carreras E, Becker J, et al. Prevalence of neurological damage in monochorionic twins with selective intrauterine growth restriction and intermittent absent or reversed end-diastolic umbilical artery flow. Ultrasound Obstet Gynecol. 2004;24:159–163
  4. Adegbite AL, Castille S, Ward S, Bajoria R. Neuromorbidity in preterm twins in relation to chorionicity and discordant birth weight. Am J Obstet Gynecol. 2004;190:156–163
  5. Fick AL, Feldstein VA, Norton ME, Wassel Fyr C, Caughey AB, Machin GA. Unequal placental sharing and birth weight discordance in monochorionic diamniotic twins. Am J Obstet Gynecol. 2006;195:178–183
  6. Lewi L, Cannie M, Blickstein I, et al. Placental sharing, birthweight discordance and vascular anastomoses in monochorionic diamniotic twin placentas. Am J Obstet Gynecol. 2007;197:587.e1–587.e8
  7. Denbow ML, Cox P, Taylor M, Hammal DM, Fisk NM. Placental angioarchitecture in monochorionic twin pregnancies: relationship to fetal growth, fetofetal transfusion syndrome, and pregnancy outcome. Am J Obstet Gynecol. 2000;182:417–426
  8. Moreira de Sa RA, Salomon LJ, Takahashi Y, Yamamoto M, Ville Y. Analysis of fetal growth after laser therapy in twin-to-twin transfusion syndrome. J Ultrasound Med. 2005;24:1213–1219
  9. Hadlock FP, Harrist RB, Martinez-Poyer J. In utero analysis of fetal growth: a sonographic weight standard. Radiology. 1991;181:129–133
  10. Lewi L, Gratacos E, Ortibus E, et al. Pregnancy and infant outcome of 80 consecutive cord coagulations in complicated monochorionic multiple pregnancies. Am J Obstet Gynecol. 2006;194:782–789
  11. Senat MV, Deprest J, Boulvain M, Paupe A, Winer N, Ville Y. Endoscopic laser surgery versus serial amnioreduction for severe twin-to-twin transfusion syndrome. N Engl J Med. 2004;351:136–144
  12. Lopriore E, Middeldorp JM, Oepkes D, Kanhai HH, Walther FJ, Vandenbussche FP. Twin anemia-polycythemia sequence in two monochorionic twin pairs without oligo-polyhydramnios sequence. Placenta. 2007;28:47–51
  13. Gratacós E, Lewi L, Muñoz B, et al. A classification system for selective intrauterine growth restriction in monochorionic pregnancies according to umbilical artery Doppler in the smaller twin. Ultrasound Obstet Gynecol. 2007;30:28–34
  14. Lewi L, Jani J, Blickstein I, et al. The outcome of monochorionic diamniotic twin gestations in the era of invasive fetal therapy: a prospective cohort. Am J Obstet Gynecol, accepted for publication
  15. Lewi L, Lewi P, Diemert A, et al. The role of ultrasound examination in the first trimester and at 16 weeks' gestation to predict fetal complications in monochorionic diamniotic twin pregnancies. Am J Obstet Gynecol, accepted for publication
  16. Mahieu-Caputo D, Meulemans A, Martinovic J, et al. M. Paradoxic activation of the renin-angiotensin system in twin-twin transfusion syndrome: an explanation for cardiovascular disturbances in the recipient. Pediatr Res. 2005;58:685–688
  17. Bajoria R, Wee LY, Anwar S, Ward S. Outcome of twin pregnancies complicated by single intrauterine death in relation to vascular anatomy of the monochorionic placenta. Hum Reprod. 1999;14:2124–2130

 Cite this article as: Lewi L, Gucciardo L, Huber A, et al. Clinical outcome and placental characteristics of monochorionic diamniotic twin pairs with early- and late-onset discordant growth. Am J Obstet Gynecol 2008;199:511.e1-511.e7.

 Reprints not available from the authors.

 Drs L. Lewi, Jani, and Huber are the recipients of a grant of the Fifth Framework Program of the European Commission (#QLG1-CT-2002-01632 EuroTwin2Twin and FP6-2006-37409 EuroSTEC). Dr Doné is the recipient of a grant within the Marie Curie Program of the European Commission (MEST CT2005 019707).

PII: S0002-9378(08)00414-6

doi: 10.1016/j.ajog.2008.04.022

American Journal of Obstetrics & Gynecology
Volume 199, Issue 5 , Pages 511.e1-511.e7 , November 2008

Article Tools

* Image Usage & Resolution