Detection of the Small‐for‐dates Twin Fetus by Ultrasound

Neilson, James P

doi:10.1111/j.1471-0528.1981.tb00932.x

Cited by 26 publications

(13 citation statements)

References 22 publications

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“…The detection of chronic placental insufficiency by repeated measurements of the biparietal diameter of the fetal head is very difficult on account of the position of the children, particularly in multiple pregnancies [8,9,19,24]. Our studies confirmed these results.…”

Section: Discussionsupporting

confidence: 94%

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Predictive value of a single CTG, ultrasound and Doppler examination to diagnose acute and chronic placental insufficiency in multiple pregnancies

Joern

Schroeder²,

Saßen³

et al. 1997

Jpme

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A non-stress test, an ultrasound biometry (biparietal and abdominal diameter) and a Doppler sonography blood flow measurement (fetal descending aorta, umbilical artery and fetal middle cerebral artery) were performed in the third trimester of 130 multiple pregnancies. These three methods were compared in terms of their prognostic value for fetal growth retardation (81 from 263 children; defined as weight at birth < 10 percentile) and a pathological "fetal outcome" (76 from 263 children, defined as 5-min-Apgar < 8, umbilical artery-pH < 7.20 and transfer to neonatal intensive care unit). Fetal growth retardation could best be predicted by means of the Doppler results for all three blood vessels ("total Doppler result") (sensitivity of 75.9%). Doppler results for all three blood vessels showed the best result in predicting a pathological "fetal outcome"; the sensitivity was 60.3%. The biometric examinations with ultrasound and the non-stress test produced worse results compared to Doppler sonography. Doppler velocimetry of only one blood vessel showed worse results compared to Doppler velocimetry of more than one blood vessel. Doppler sonography should be performed as a routine test for all multiple pregnancies. More intensive pregnancy surveillance is urgently recommended with pathological findings.

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Section: Discussionsupporting

confidence: 94%

“…With repeated measurements of the biparietal diameter, the sensitivity to detect growth retardation in one of the fetuses was 56% [24].…”

Section: Introductionmentioning

confidence: 98%

Predictive value of a single CTG, ultrasound and Doppler examination to diagnose acute and chronic placental insufficiency in multiple pregnancies

Joern

Schroeder²,

Saßen³

et al. 1997

Jpme

View full text Add to dashboard Cite

show abstract

“…The same applies to the comparison of the sensitivities of Doppler velocimetry (60%) and the nonstress test (10%) regarding the identification of an intrauterine asphyxia [15]. The problems of fetal biometry in multiple gestation [16,17] and the small predictive value of the nonstress test are well known from other studies [18,19].…”

Section: Introductionmentioning

confidence: 90%

Correlation of Doppler Velocimetry Findings in Twin Pregnancies Including Course of Pregnancy and Fetal Outcome

Joern¹,

Rath²

2000

Fetal Diagn Ther

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Objective: Subject of the study was the significance of umbilical artery Doppler velocimetry findings for the further course of pregnancy and fetal outcome in cases of twin pregnancies. Methods: In 206 cases of twin pregnancy, the umbilical artery was examined using Doppler velocimetry in the median 9 days prior to delivery, and the result was correlated with the further course of pregnancy and fetal outcome. 174 pregnancies showed normal Doppler findings of the umbilical artery (group A), 32 twin pregnancies showed pathological Doppler findings of at least one twin (group B). The median of the maternal age and the parity between the groups were not different. Results: In group B (pathological Doppler findings), intrauterine growth retardation and pre-eclampsia occurred 5 times more often than in group A (normal Doppler findings). The total rate of cesarean sections was not different between the study populations; the rate of deliveries by cesarean section in group B was significantly increased by a factor of 2.4 due to a pathological CTG. The median birth weight and the gestational age at birth were significantly lower in group B (1,660 g; 35 weeks) as compared to group A (2,460 g; 37 weeks; p < 0.001). In group B, the rate of premature deliveries up to reaching the 34th week of gestation was 3.4 times higher; the rate of SGA newborns was 6.3 times higher. Perinatal mortality was increased by a factor of 1.5 in group B compared to group A. Conclusion: The Doppler velocimetry findings have considerable effects on the further course of a multiple pregnancy. In case of pathological Doppler findings, early hospitalization and close monitoring of the pregnancy should be performed. In cases of additional pathological findings (maternal illness, pathological Doppler findings of fetal blood vessels), termination of the pregnancy has to be considered.

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“…Estimation of fetal size by abdominal palpation is made more difficult by the presence of the other twin, and biochemical investigation is of little value because only the combined endocrine output from both fetoplacental units can be assessed (Westergaard et al 1985). Complex ultrasound measurements of twin fetuses may be highly sensitive in predicting SGA babies (Neilson 1981), and early reports of Doppler ultrasound indicate potential usefulness (Farmakides et al 1985;Giles et al 1985;Nimrod et al 1987) but these techniques are not yet widely available. Tape measurement of symphysis-fundal height is becoming a widely used method to identify the SGA fetus in singleton pregnancies with reported sensitivities ranging between 55% (Rosenberg et al 1982) and 89% (Belizan etal.…”

mentioning

confidence: 99%

Tape measurement of symphysis‐fundal height in twin pregnancies

Neilson

Verkuyl

Bannerman

1988

BJOG

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Summary. We hypothesized that tape measurement of symphysis‐fundal height could be useful in detecting multiple pregnancies, and in such cases in predicting preterm labour and identifying small‐for‐gestationalage (SGA) fetuses. Although mean fundal height is substantially greater in twin than in singleton pregnancies, the value of the technique to detect multiple pregnancies may be limited because combined birthweight is less and the frequency of SGA fetuses is greater in undiagnosed than in diagnosed twin pregnancies. We found no evidence that the measured fundal height is greater in pregnancies going on to preterm delivery, and we suggest that the commonly accepted theory that the high rate of preterm labour in twin pregnancies results simply from uterine overdistension be reappraised. Nevertheless, fundal height measurement was of value in identifying pregnancies in which both babies were SGA and is therefore recommended as a simple, inexpensive and non‐invasive technique.

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Detection of the Small‐for‐dates Twin Fetus by Ultrasound

Cited by 26 publications

References 22 publications

Predictive value of a single CTG, ultrasound and Doppler examination to diagnose acute and chronic placental insufficiency in multiple pregnancies

Predictive value of a single CTG, ultrasound and Doppler examination to diagnose acute and chronic placental insufficiency in multiple pregnancies

Correlation of Doppler Velocimetry Findings in Twin Pregnancies Including Course of Pregnancy and Fetal Outcome

Tape measurement of symphysis‐fundal height in twin pregnancies

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