Ultrasound for diagnosis of birth weight discordance in twin pregnancies

Jahanfar, Shayesteh; Ho, Jacqueline J; Jaafar, Sharifah Halimah; Abraha, Iosief; Nisenblat, Vicki; Ellis, Ursula; Noura, Mohaddesseh

doi:10.1002/14651858.cd012553.pub2

Cited by 5 publications

(3 citation statements)

References 97 publications

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“…Chorionicity and amnionicity were diagnosed by ultrasound between 7 and 14 weeks’ gestation and confirmed by postnatal placental pathology. Growth discordance between twins was defined as a twin birth weight difference ≥ 20% and calculated by the following equation (large fetal birth weight-small fetal birth weight) / large fetal birth weight × 100%) [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

Pregnancy outcomes and risk factors for preeclampsia in dichorionic twin pregnancies after in vitro fertilization: a five-year retrospective study

Dai

Pan

Lan

et al. 2022

BMC Pregnancy Childbirth

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Background Both in vitro fertilization (IVF) and preeclampsia (PE) were associated with placental dysfunction. Although IVF can increase the incidence of PE, the pregnancy outcomes and risk factors for preeclampsia in dichorionic twin pregnancies conceived via IVF remain unclear. This study aimed to investigate the pregnancy outcomes and the risk factors for preeclampsia in dichorionic twin pregnancies conceived through IVF compared to those conceived after natural conception (NC). Methods This retrospective observational study enrolled 181 dichorionic twin pregnancy women with preeclampsia from 2016 to 2020. According to the mode of conception, they were allocated into IVF (n = 117) and NC groups (n = 64). The clinical characteristics of preeclampsia and pregnancy outcomes between the two groups were compared by using Student’s t test, chi-square test, and Fisher’s exact test, and logistic regression models were used to obtain adjusted odds ratios (aOR) with 95% confidence intervals (CI) for risk factors of early-onset preeclampsia. Results The incidence of early-onset PE and growth discordance in dichorionic twin pregnancies with PE is significantly higher in IVF-PE group than in NC group (78.60% vs 43.80%, P < 0.001, 11.10% vs 25.00%, P = 0.015). We found that IVF (aOR = 4.635, 95% CI: 2.130–10.084, P < 0.001) and growth discordance (aOR = 3.288; 95% CI: 1.090–9.749, P < 0.05) increased the incidence of early-onset PE. Conclusions In preeclamptic dichorionic twin pregnancies, IVF and growth discordance were associated with the increased incidence of early-onset PE. The underlying mechanism for the relationship between IVF and early-onset PE or growth discordance may be placental dysfunction.

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Section: Methodsmentioning

confidence: 99%

Pregnancy outcomes and risk factors for preeclampsia in dichorionic twin pregnancies after in vitro fertilization: a five-year retrospective study

Dai

Pan

Lan

et al. 2022

BMC Pregnancy Childbirth

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“…A 2021 Cochrane review concluded that sonographic EFW was unreliable for the diagnosis of BW discordance in twins, as it detected BW discordance of 20% and 25% only half of the time 21 . The diagnosis of BW discordance has been associated with high specificity but low sensitivity, affirming our results 17 .…”

Section: Accuracy Of Estimating Fetal Weight and Discordancementioning

confidence: 99%

“…This finding differs from that of a previous study of 283 twin pregnancies, in which the accuracy of BW prediction was not affected by fetal gender 27 . A Cochrane review addressing the sensitivity and specificity of sonographic EFW in pregnancies with gender-concordant vs gender-discordant twins lacked sufficient data for analysis of this parameter 21 .…”

Section: Fetal Gendermentioning

confidence: 99%

Accuracy of sonographic fetal weight estimation and prediction of birth‐weight discordance in twin pregnancy: large single‐center study

Rosen

Zamir

Lopian

et al. 2023

Ultrasound in Obstet & Gyne

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ObjectivesTo determine the accuracy of sonographic fetal weight estimation in twin gestations in predicting actual birthweight and birthweight discordance. To evaluate maternal and fetal characteristics that may affect estimated fetal weight accuracy in twins.MethodsThis was a retrospective cohort study of all twins delivered at a single tertiary medical center between 2010 and 2021. Twin gestations who had a sonographic estimated fetal weight (sEFW) performed in the week preceding delivery were included in this study. Statistical analysis was performed to evaluate the strength of the correlation between sonographic estimated fetal weight and actual birthweight, and to determine the impact of maternal and fetal parameters on the accuracy of sonographic estimation.ResultsThe study included 2154 twin pregnancies. There was a strong correlation between sonographic estimated fetal weights and corresponding birthweights (r=0.922, p<0.001). Strong correlations were observed for both the presenting and non‐presenting co‐twins as well as the larger and smaller co‐twins (all r=0.921‐0.928, p<0.001). The overall mean absolute error of the sEFW was 7.41±6.8%. This error was greater for the non‐presenting twin compared to the presenting twin. (7.94±6.62% vs. 6.99±5.64%, p<0.001) and for the smaller twin compared to the larger co‐twin (8.56±7.5% vs. 6.58±5.47%, p<0.001). Advanced gestational age at scanning was inversely correlated to the mean absolute error of sEFW. Multivariate logistic regression revealed that an earlier gestational age at scanning, being the non‐presenting twin and being the smaller co‐twin were independent risk factors for sonographic fetal weight inaccuracy. Pregnancies in which the presenting twin was estimated to be the smaller co‐twin had twice the rate of false positive birth‐weight discordance (BWD) compared to pregnancies in which the presenting twin was estimated to be the larger co‐twin (33.7% vs. 14.8% for BWD‐15%, 31.7% vs. 19.2% for BWD‐20%, and 35.1% vs. 12.5% for BWD 25%, all p<0.001). The error in sEFW discordance was not related to chorionicity, the position of the presenting fetus or gestational age at the time of fetal weight estimation.ConclusionsSonographic estimation of fetal weight within 7 days of delivery accurately predicts birthweight in twin pregnancies. sEFW accuracy is reduced for the non‐presenting, the smaller co‐twins and when delivery occurs at an earlier gestational age. Sonographic estimation of fetal weight discordance is less accurate when the presenting twin is the smaller co‐twin.This article is protected by copyright. All rights reserved.

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Interventions during pregnancy to prevent preterm birth: an overview of Cochrane systematic reviews

Medley

Vogel

Care

et al. 2018

Cochrane Database of Systematic Reviews

121

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Ultrasound for diagnosis of birth weight discordance in twin pregnancies

Cited by 5 publications

References 97 publications

Pregnancy outcomes and risk factors for preeclampsia in dichorionic twin pregnancies after in vitro fertilization: a five-year retrospective study

Pregnancy outcomes and risk factors for preeclampsia in dichorionic twin pregnancies after in vitro fertilization: a five-year retrospective study

Accuracy of sonographic fetal weight estimation and prediction of birth‐weight discordance in twin pregnancy: large single‐center study

Interventions during pregnancy to prevent preterm birth: an overview of Cochrane systematic reviews

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