Doppler ultrasound prediction of fetal outcome in twin pregnancies

Nimrod, Carl; Davies, D.; Harder, James A.; Dempster, C.; Dodd, Gail; McDicken, Norman; Nicholson, S.

doi:10.1016/0002-9378(87)90293-6

Cited by 50 publications

(13 citation statements)

References 9 publications

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“…Twins with abnormal UA waveforms deliver earlier, show more structural malformations and are of lower birth weight compared to twins with normal umbilical artery velocimetry 8 . In addition, Doppler waveform abnormalities of the fetal descending aorta and UA show a 50% sensitivity for unsatisfactory outcome 9 .…”

mentioning

confidence: 99%

The cerebroplacental Doppler ratio and neonatal outcome in diamnionic monochorionic and dichorionic twins

Gaziano

Terrell³

et al. 2001

J Matern Fetal Neonatal Med

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Objective: Neonatal outcome in twins was studied in relation to the cerebroplacental ratio (CPR). Methods: Seventy-five infants from twin pregnancies with fetal Doppler data obtained within 3 weeks of delivery were candidates for study (23 infants from diamnionic monochorionic and 52 infants from diamnionic dichorionic twin pregnancies). Multivariate regression analyses were expanded to include 114 twin infants (34 diamnionic monochorionic and 80 diamnionic dichorionic twins). Patients with twin transfusion syndrome were excluded from analysis in the monochorionic group. Targeted ultrasound examination with biometry was performed, and Doppler resistance index (RI) of the umbilical artery (UA) and the middle cerebral artery (MCA) were obtained, and the CPR, a measure of blood flow redistribution, was calculated. Outcome variables included major complications, growth restriction, days of ventilator and oxygen use, days in the neonatal intensive care unit and length of stay. Results:The CPR was correlated more highly with adverse outcomes such as birth weight, special-care nursery days and length of stay than were the UA RI or the MCA RI. The CPR was significantly lower in monochorionic compared with dichorionic twins (1.12 vs. 1.27, p = 0.01). Multivariate regression analyses conducted separately on each twin group also demonstrated that CPR was superior to UA RI and MCA RI in predicting length of stay and restricted growth. Among the Doppler variables, the CPR showed the highest sensitivity for growth restriction (67%). C onclusion: In twins, CPR was superior to UA RI and MCA RI in predicting adverse neonatal events.

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mentioning

confidence: 99%

The cerebroplacental Doppler ratio and neonatal outcome in diamnionic monochorionic and dichorionic twins

Gaziano

Terrell³

et al. 2001

J Matern Fetal Neonatal Med

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“…Behrens et al [13] described 2 cases of discordant twins who were followed by Doppler velocimetry, in which both smaller fetuses demonstrated pathological flow velocity waveforms before death. A number of articles [14][15][16] have eval uated umbilical artery flow velocity wave forms as a predictor of fetal discordance in twins, but none found the S/D ratios to differ 20 Tadmor/Nitzan/Rabinowitz/ Skomorovsky/Aboulafia/Diamant…”

Section: Discussionmentioning

confidence: 99%

Prediction of Second Trimester Intrauterine Growth Retardation and Fetal Death in a Discordant Twin by First Trimester Measurements

et al. 1995

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Ultrasound examination at 9 weeks of gestation in a 34-year-old primigravida showed a twin pregnancy, with discrepancy in the sizes of the two gestational sacs, whereas the crownrump lengths and fetal heart rates were virtually identical – the result being an abnormal sac size/crownrump length ratio (early oligohydramnios). By 14 weeks discordant heart rates and umbilical artery flow velocities were detected, the discordance between the twins increasing as pregnancy progressed. Biparietal diameters, femoral lengths, and abdominal circumferences were also progressively discordant, and at 28 weeks the smaller twin had no heart beat. At 30 weeks the patient was delivered of a live 1,350-gram infant and a 400-gram dead fetus. This case suggests, in contradistinction to several previous reports, that fetal discordance in twin pregnancies (and perhaps intrauterine growth retardation in general) may be present as early as the first trimester.

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“…Many authors found variable associations between abnormal umbilical artery velocity waveforms and a variety of fetal and neonatal complications 3±11 and abnormal fetal heart rate monitoring 12 (Table 1). Some investigators looked away from the umbilical artery at the fetal aorta 13,14 and the fetal internal carotid circulation 15 and found associations with fetal and neonatal compromise. Some investigators used arbitrary umbilical artery systolic diastolic (SD) ratio intertwin differences of > 0.4 as diagnostic criteria for a pathological difference.…”

Section: Uncontrolled Studiesmentioning

confidence: 99%

Doppler ultrasound in twin pregnancy

Giles

2001

Fet. Mat. Med. Rev.

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Doppler ultrasound prediction of fetal outcome in twin pregnancies

Cited by 50 publications

References 9 publications

The cerebroplacental Doppler ratio and neonatal outcome in diamnionic monochorionic and dichorionic twins

The cerebroplacental Doppler ratio and neonatal outcome in diamnionic monochorionic and dichorionic twins

Prediction of Second Trimester Intrauterine Growth Retardation and Fetal Death in a Discordant Twin by First Trimester Measurements

Doppler ultrasound in twin pregnancy

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