The role of ultrasound in the prediction of birth weight discordance in twin pregnancies: are we there yet?

Abstract

The accuracy of ultrasound in the prediction of BWD is limited, particularly in pregnancies without fetal growth restriction. Clinical decisions should not rely on BWD alone.

Prediction of Monochorionic Diamniotic Twin Pregnancy Outcomes Based on Early Second Trimester Ultrasound

“…Conversely, other studies have found that secondtrimester ultrasound discordance in twins has poor predictive value for adverse perinatal outcomes, irrespective of chorionicity [1,[18][19][20]. Although in some investigations, second-trimester EFW discordance correlated with birth-weight discordance ≥20-25%, the predictive accuracy was low, thus preventing its wide practical clinical use [7,8].…”

Placental T2* estimated by magnetic resonance imaging and fetal weight estimated by ultrasound in the prediction of birthweight differences in dichorionic twin pairs

“…In addition, the risk is further increased in twin pregnancies with birthweight (BW) discordance [2][3][4]. Intertwin BW discordance has various definitions, but most commonly it is expressed as an intertwin BW difference ≥ 20 % relative to the larger twin [2,[4][5][6][7][8], and it occurs in approximately 16 % of all twin pregnancies [4].…”

“…These methods have been extensively studied throughout the last decades. The majority of publications have reached the conclusion of poor sensitivity in predicting intertwin BW discordance [5,6,[9][10][11][12][13], however the performance is better when performed near delivery [7,8,[13][14][15]. Recently, Hehir et al [13] investigated the performance of ultrasound EFW in predicting intertwin BW discordance at different gestational ages.…”

Early prognostic factors of outcomes in monochorionic twin pregnancy: systematic review and meta-analysis

“…In this systematic review, we attempted to address the problem by creating different growth restriction groups so as to be as inclusive as possible. (78). However, most studies in our search that reported growth based on postnatal measures used BWD as opposed to LBW, therefore it was decided to include BWD in our systematic review.…”