The value of umbilical artery Doppler velocimetry in the antenatal surveillance of uncomplicated monochorionic twin pregnancies

Hack, K.E.A.; Kaandorp, Joepe J.; Derks, Jan; Elias, Sjoerd G.; Pistorius, Lourens R.; Visser, Gerard H.A.

doi:10.1002/uog.5363

Cited by 12 publications

(15 citation statements)

References 24 publications

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“…Therefore, early diagnosis of chorionicity is vital in twine or multiple pregnancies [6]. So, procedures have been suggested in precise monitoring of fetuses in monochorionic twin pregnancies to prevent morbidity and mortality [4,9,[11][12][13]. It should be noted, however, none of these pathologic entities were present, neither in the study by Ingec et al, nor in the present study.…”

Section: Discussioncontrasting

confidence: 56%

“…The determination of chorionicity is important for predicting the prognosis of pregnancy, because it has been shown that in monochorionic cases, vascular anastomoses or imbalanced placental vascular distribution in the two placentas may lead into the twin insufficiency syndrome. In addition, hemodynamic imbalances may jeopardize the health of both fetuses and cause significant consequences [4,9,10]. A worse prognosis in monochorionic pregnancies is possibly due to the twin to twin transfusion syndrome, growth restriction, and the twin reverse arterial perfusion syndrome in such cases.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, they were significantly higher in monochorionic than in dichorionic pregnancies. In a study by Hack et al [4], it was shown that in monochorionic pregnancies, abnormalities in color Doppler findings of the umbilical arteries could reflect pregnancies at risk for preterm delivery, low birth weight and morbidity. Zuckerwise et al [27] also concluded that in monochorionic twin pregnancies with fetal growth retardation, color Doppler ultrasonographic findings might be abnormal.…”

Section: Discussionmentioning

confidence: 99%

“…Zuckerwise et al [27] also concluded that in monochorionic twin pregnancies with fetal growth retardation, color Doppler ultrasonographic findings might be abnormal. On the other hand, it has been shown that in uncomplicated monochorionic pregnancies before the week 28, color Doppler ultrasonographic findings might be abnormal [28] and single abnormal findings may indicate the presence of certain placental anastomosis and not essentially a hazardous, unfavorable condition [4,10,23]. So, it is important to include abnormal twin pregnancies in terms of neonatal-fetal abnormalities in future studies.…”

Section: Discussionmentioning

confidence: 99%

“…The rate of pregnancy related complications are associated with zygosity and chorionicity. It has been shown that the perinatal morbidity and mortality rate, particularly neurologic problems, is higher in monochorionic than in dichorionic fetuses [4,5]. With advancing pregnancy age beyond second and third trimesters the possibility of evaluating chorionicity with conventional ultrasound decreases dramatically.…”

Section: Introductionmentioning

confidence: 99%

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The Role of Second and Third Trimester Umbilical Artery Doppler Ultrasonography in Determining Chorionicity of Twin Pregnancies

Samani

Ghasemzadeh²,

Mousavi

2016

AJLSR

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Introduction: Determining the chorionicity in monozygotic twins is of pivotal importance, because it has been shown that monochorionic fetuses compared to dichorionic counterparts bear a higher risk f morbidity and mortality. Using conventional ultrasonography in this regard is along with accurate results provided that it is conducted before 14 weeks' gestation. It has been suggested that differences between color Doppler ultrasonographic indices obtained from the umbilical arteries of twins may result in the prediction of chorionicity. Nevertheless, relevant available data are very scarce. This study aimed to examine the role of umbilical artery Doppler ultrasound in the second and third trimesters in determining chorionicity in twin pregnancies Methods: A total 20 monochorionic monozygotic pregnancies and 30 dichorionic monozygotic pregnancies between 28 and 39 weeks' gestation were examined by color Doppler study of the umbilical arteries. The pulsatility index (PI), resistive index (RI) and the S to D ratio (S/D) of the umbilical arteries and their differences in each group independently were compared between twins. Results: The mean PI difference between the two umbilical arteries did not differ significantly between the two groups; however, the mean differences of RI and S/D were significantly higher in the dichorionic group (0.006 ± 0.01 vs. 0.04 ± 0.01, P = 0.02, and 0.54 ± 0.09 vs. 0.33 ± 0.05, P = 0.04, respectively). When the difference between the two fetuses in terms of the umbilical artery RI difference exceeded 0.05 and over, the probability of dichorionic pregnancy was present (sensitivity, 60% and specificity, 65%). The difference of S/D was not acceptable as to the diagnostic accuracy in this regard. Conclusions: On the basis of our findings, the results of umbilical artery color Doppler study in twin pregnancies aged 28-39 weeks' gestation could be used for determining chorionicity. To reach more solid conclusions, further studies with larger sample sizes are recommended to be carried out.

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