Sonographic evaluation of umbilical cord thickness in monochorionic diamniotic twin pregnancies
Objective To develop a nomogram of the thickness of the umbilical cord (UC) and its components in monochorionic diamniotic (MCDA) twin pregnancies. Methods This prospective longitudinal study involved 47 MCDA twin pregnancies (94 fetuses) between 18 and 33 weeks of gestation. Ultrasound assessments...
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| Veröffentlicht in: | Prenatal diagnosis 2022-05, Vol.42 (5), p.636-642 |
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| creator | Nunes, Clarissa Moraes Biancolin, Sckarlet Ernandes Miyadahira, Mariana Yumi Peres, Stela Verzinhasse Carvalho, Mario Henrique Burlacchini Francisco, Rossana Pulcineli Vieira Brizot, Maria de Lourdes |
| description | Objective
To develop a nomogram of the thickness of the umbilical cord (UC) and its components in monochorionic diamniotic (MCDA) twin pregnancies.
Methods
This prospective longitudinal study involved 47 MCDA twin pregnancies (94 fetuses) between 18 and 33 weeks of gestation. Ultrasound assessments of UC cross‐sections and measurements of the umbilical cord area (UCA), the umbilical vein area (UVA), the umbilical artery area (UAA), and the Wharton jelly area (WJA) were made. The UC measurements were correlated with gestational ages. Reference values for the gestational ages of MCDA pregnancies were determined and compared with those of dichorionic twins and singletons. The cases which developed selective intrauterine growth restriction were contrasted with normal cases.
Results
A positive correlation was found between all UC components and gestational age and fetal weight. The UCA of MCDA fetuses was significantly larger than that of DC fetuses (p |
| doi_str_mv | 10.1002/pd.6141 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2648897326</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2648897326</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2751-5786a5a37aa1e48bdf64ba206dd67c4a8c4bd93e5a1699fea146438f653dee0c3</originalsourceid><addsrcrecordid>eNp10F1LwzAUBuAgipsf-A-k4IWCbCZNm6aXMj9hoKBeh9MkdZltUpNW8d-bOfVC8CoH8pyXw4vQAcFTgnF61qkpIxnZQGOCy2KC05RuojEmcaY8JyO0E8IyQp6WxTYa0ZyWlBV8jMSDs-7ZQ7cwMtFv0AzQG2cTVydDW5nGSGgS6bxK-iherA4hMTZp45ZcOB9p3FMGWmtcH8f-Pf52Xj9bsNLosIe2amiC3v9-d9HT1eXj7GYyv7u-nZ3PJzItcjLJC84gB1oAEJ3xStUsqyDFTClWyAy4zCpVUp0DYWVZayAZyyivWU6V1ljSXXSyzu28ex106EVrgtRNA1a7IYiUZZyXBU1ZpEd_6NIN3sbroorFMJ5jGtXxWknvQvC6Fp03LfgPQbBYdS46JVadR3n4nTdUrVa_7qfkCE7X4N00-uO_HHF_8RX3CcsiiqI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2653968503</pqid></control><display><type>article</type><title>Sonographic evaluation of umbilical cord thickness in monochorionic diamniotic twin pregnancies</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><creator>Nunes, Clarissa Moraes ; Biancolin, Sckarlet Ernandes ; Miyadahira, Mariana Yumi ; Peres, Stela Verzinhasse ; Carvalho, Mario Henrique Burlacchini ; Francisco, Rossana Pulcineli Vieira ; Brizot, Maria de Lourdes</creator><creatorcontrib>Nunes, Clarissa Moraes ; Biancolin, Sckarlet Ernandes ; Miyadahira, Mariana Yumi ; Peres, Stela Verzinhasse ; Carvalho, Mario Henrique Burlacchini ; Francisco, Rossana Pulcineli Vieira ; Brizot, Maria de Lourdes</creatorcontrib><description>Objective
To develop a nomogram of the thickness of the umbilical cord (UC) and its components in monochorionic diamniotic (MCDA) twin pregnancies.
Methods
This prospective longitudinal study involved 47 MCDA twin pregnancies (94 fetuses) between 18 and 33 weeks of gestation. Ultrasound assessments of UC cross‐sections and measurements of the umbilical cord area (UCA), the umbilical vein area (UVA), the umbilical artery area (UAA), and the Wharton jelly area (WJA) were made. The UC measurements were correlated with gestational ages. Reference values for the gestational ages of MCDA pregnancies were determined and compared with those of dichorionic twins and singletons. The cases which developed selective intrauterine growth restriction were contrasted with normal cases.
Results
A positive correlation was found between all UC components and gestational age and fetal weight. The UCA of MCDA fetuses was significantly larger than that of DC fetuses (p < 0.001) at the expense of a larger WJA (p < 0.001) and similar to that of singleton pregnancies. The MCDA fetuses with an estimated fetal weight below the 10th percentile had a smaller UCA than fetuses with a normal estimated weight (p < 0.001).
Conclusion
The MCDA twins exhibited a thicker UC than that of dichorionic twins.
Key points
What's already known about the topic?
The umbilical cord can have its characteristics evaluated prenatally by ultrasound.
Dichorionic fetuses have a thicker umbilical cord than single fetuses.
What does this study add?
Monochorionic fetuses have an umbilical cord thicker than that of dichorionic fetuses and of similar thickness as that of single fetuses.
A thicker umbilical cord is due to an enlarged Whartonjelly area.
The differences in cord thickness are possibly a consequence of placental shunts and amniotic fluid balance.
Monochorionic growth‐restricted fetuses have thinner umbilical cords.</description><identifier>ISSN: 0197-3851</identifier><identifier>EISSN: 1097-0223</identifier><identifier>DOI: 10.1002/pd.6141</identifier><identifier>PMID: 35393678</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Correlation analysis ; Female ; Fetal Growth Retardation - diagnostic imaging ; Fetal Weight ; Fetuses ; Gestational Age ; Humans ; Longitudinal Studies ; Nomograms ; Pregnancy ; Pregnancy, Twin ; Prospective Studies ; Thickness ; Twins ; Twins, Dizygotic ; Twins, Monozygotic ; Ultrasonography, Prenatal ; Umbilical Arteries - diagnostic imaging ; Umbilical cord ; Umbilical Cord - diagnostic imaging ; Umbilical vein</subject><ispartof>Prenatal diagnosis, 2022-05, Vol.42 (5), p.636-642</ispartof><rights>2022 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2751-5786a5a37aa1e48bdf64ba206dd67c4a8c4bd93e5a1699fea146438f653dee0c3</citedby><cites>FETCH-LOGICAL-c2751-5786a5a37aa1e48bdf64ba206dd67c4a8c4bd93e5a1699fea146438f653dee0c3</cites><orcidid>0000-0002-7547-4011</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpd.6141$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpd.6141$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35393678$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nunes, Clarissa Moraes</creatorcontrib><creatorcontrib>Biancolin, Sckarlet Ernandes</creatorcontrib><creatorcontrib>Miyadahira, Mariana Yumi</creatorcontrib><creatorcontrib>Peres, Stela Verzinhasse</creatorcontrib><creatorcontrib>Carvalho, Mario Henrique Burlacchini</creatorcontrib><creatorcontrib>Francisco, Rossana Pulcineli Vieira</creatorcontrib><creatorcontrib>Brizot, Maria de Lourdes</creatorcontrib><title>Sonographic evaluation of umbilical cord thickness in monochorionic diamniotic twin pregnancies</title><title>Prenatal diagnosis</title><addtitle>Prenat Diagn</addtitle><description>Objective
To develop a nomogram of the thickness of the umbilical cord (UC) and its components in monochorionic diamniotic (MCDA) twin pregnancies.
Methods
This prospective longitudinal study involved 47 MCDA twin pregnancies (94 fetuses) between 18 and 33 weeks of gestation. Ultrasound assessments of UC cross‐sections and measurements of the umbilical cord area (UCA), the umbilical vein area (UVA), the umbilical artery area (UAA), and the Wharton jelly area (WJA) were made. The UC measurements were correlated with gestational ages. Reference values for the gestational ages of MCDA pregnancies were determined and compared with those of dichorionic twins and singletons. The cases which developed selective intrauterine growth restriction were contrasted with normal cases.
Results
A positive correlation was found between all UC components and gestational age and fetal weight. The UCA of MCDA fetuses was significantly larger than that of DC fetuses (p < 0.001) at the expense of a larger WJA (p < 0.001) and similar to that of singleton pregnancies. The MCDA fetuses with an estimated fetal weight below the 10th percentile had a smaller UCA than fetuses with a normal estimated weight (p < 0.001).
Conclusion
The MCDA twins exhibited a thicker UC than that of dichorionic twins.
Key points
What's already known about the topic?
The umbilical cord can have its characteristics evaluated prenatally by ultrasound.
Dichorionic fetuses have a thicker umbilical cord than single fetuses.
What does this study add?
Monochorionic fetuses have an umbilical cord thicker than that of dichorionic fetuses and of similar thickness as that of single fetuses.
A thicker umbilical cord is due to an enlarged Whartonjelly area.
The differences in cord thickness are possibly a consequence of placental shunts and amniotic fluid balance.
Monochorionic growth‐restricted fetuses have thinner umbilical cords.</description><subject>Correlation analysis</subject><subject>Female</subject><subject>Fetal Growth Retardation - diagnostic imaging</subject><subject>Fetal Weight</subject><subject>Fetuses</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Nomograms</subject><subject>Pregnancy</subject><subject>Pregnancy, Twin</subject><subject>Prospective Studies</subject><subject>Thickness</subject><subject>Twins</subject><subject>Twins, Dizygotic</subject><subject>Twins, Monozygotic</subject><subject>Ultrasonography, Prenatal</subject><subject>Umbilical Arteries - diagnostic imaging</subject><subject>Umbilical cord</subject><subject>Umbilical Cord - diagnostic imaging</subject><subject>Umbilical vein</subject><issn>0197-3851</issn><issn>1097-0223</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10F1LwzAUBuAgipsf-A-k4IWCbCZNm6aXMj9hoKBeh9MkdZltUpNW8d-bOfVC8CoH8pyXw4vQAcFTgnF61qkpIxnZQGOCy2KC05RuojEmcaY8JyO0E8IyQp6WxTYa0ZyWlBV8jMSDs-7ZQ7cwMtFv0AzQG2cTVydDW5nGSGgS6bxK-iherA4hMTZp45ZcOB9p3FMGWmtcH8f-Pf52Xj9bsNLosIe2amiC3v9-d9HT1eXj7GYyv7u-nZ3PJzItcjLJC84gB1oAEJ3xStUsqyDFTClWyAy4zCpVUp0DYWVZayAZyyivWU6V1ljSXXSyzu28ex106EVrgtRNA1a7IYiUZZyXBU1ZpEd_6NIN3sbroorFMJ5jGtXxWknvQvC6Fp03LfgPQbBYdS46JVadR3n4nTdUrVa_7qfkCE7X4N00-uO_HHF_8RX3CcsiiqI</recordid><startdate>202205</startdate><enddate>202205</enddate><creator>Nunes, Clarissa Moraes</creator><creator>Biancolin, Sckarlet Ernandes</creator><creator>Miyadahira, Mariana Yumi</creator><creator>Peres, Stela Verzinhasse</creator><creator>Carvalho, Mario Henrique Burlacchini</creator><creator>Francisco, Rossana Pulcineli Vieira</creator><creator>Brizot, Maria de Lourdes</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7T7</scope><scope>7TK</scope><scope>7TM</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7547-4011</orcidid></search><sort><creationdate>202205</creationdate><title>Sonographic evaluation of umbilical cord thickness in monochorionic diamniotic twin pregnancies</title><author>Nunes, Clarissa Moraes ; Biancolin, Sckarlet Ernandes ; Miyadahira, Mariana Yumi ; Peres, Stela Verzinhasse ; Carvalho, Mario Henrique Burlacchini ; Francisco, Rossana Pulcineli Vieira ; Brizot, Maria de Lourdes</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2751-5786a5a37aa1e48bdf64ba206dd67c4a8c4bd93e5a1699fea146438f653dee0c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Correlation analysis</topic><topic>Female</topic><topic>Fetal Growth Retardation - diagnostic imaging</topic><topic>Fetal Weight</topic><topic>Fetuses</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Nomograms</topic><topic>Pregnancy</topic><topic>Pregnancy, Twin</topic><topic>Prospective Studies</topic><topic>Thickness</topic><topic>Twins</topic><topic>Twins, Dizygotic</topic><topic>Twins, Monozygotic</topic><topic>Ultrasonography, Prenatal</topic><topic>Umbilical Arteries - diagnostic imaging</topic><topic>Umbilical cord</topic><topic>Umbilical Cord - diagnostic imaging</topic><topic>Umbilical vein</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nunes, Clarissa Moraes</creatorcontrib><creatorcontrib>Biancolin, Sckarlet Ernandes</creatorcontrib><creatorcontrib>Miyadahira, Mariana Yumi</creatorcontrib><creatorcontrib>Peres, Stela Verzinhasse</creatorcontrib><creatorcontrib>Carvalho, Mario Henrique Burlacchini</creatorcontrib><creatorcontrib>Francisco, Rossana Pulcineli Vieira</creatorcontrib><creatorcontrib>Brizot, Maria de Lourdes</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Prenatal diagnosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nunes, Clarissa Moraes</au><au>Biancolin, Sckarlet Ernandes</au><au>Miyadahira, Mariana Yumi</au><au>Peres, Stela Verzinhasse</au><au>Carvalho, Mario Henrique Burlacchini</au><au>Francisco, Rossana Pulcineli Vieira</au><au>Brizot, Maria de Lourdes</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sonographic evaluation of umbilical cord thickness in monochorionic diamniotic twin pregnancies</atitle><jtitle>Prenatal diagnosis</jtitle><addtitle>Prenat Diagn</addtitle><date>2022-05</date><risdate>2022</risdate><volume>42</volume><issue>5</issue><spage>636</spage><epage>642</epage><pages>636-642</pages><issn>0197-3851</issn><eissn>1097-0223</eissn><abstract>Objective
To develop a nomogram of the thickness of the umbilical cord (UC) and its components in monochorionic diamniotic (MCDA) twin pregnancies.
Methods
This prospective longitudinal study involved 47 MCDA twin pregnancies (94 fetuses) between 18 and 33 weeks of gestation. Ultrasound assessments of UC cross‐sections and measurements of the umbilical cord area (UCA), the umbilical vein area (UVA), the umbilical artery area (UAA), and the Wharton jelly area (WJA) were made. The UC measurements were correlated with gestational ages. Reference values for the gestational ages of MCDA pregnancies were determined and compared with those of dichorionic twins and singletons. The cases which developed selective intrauterine growth restriction were contrasted with normal cases.
Results
A positive correlation was found between all UC components and gestational age and fetal weight. The UCA of MCDA fetuses was significantly larger than that of DC fetuses (p < 0.001) at the expense of a larger WJA (p < 0.001) and similar to that of singleton pregnancies. The MCDA fetuses with an estimated fetal weight below the 10th percentile had a smaller UCA than fetuses with a normal estimated weight (p < 0.001).
Conclusion
The MCDA twins exhibited a thicker UC than that of dichorionic twins.
Key points
What's already known about the topic?
The umbilical cord can have its characteristics evaluated prenatally by ultrasound.
Dichorionic fetuses have a thicker umbilical cord than single fetuses.
What does this study add?
Monochorionic fetuses have an umbilical cord thicker than that of dichorionic fetuses and of similar thickness as that of single fetuses.
A thicker umbilical cord is due to an enlarged Whartonjelly area.
The differences in cord thickness are possibly a consequence of placental shunts and amniotic fluid balance.
Monochorionic growth‐restricted fetuses have thinner umbilical cords.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35393678</pmid><doi>10.1002/pd.6141</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-7547-4011</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0197-3851 |
| ispartof | Prenatal diagnosis, 2022-05, Vol.42 (5), p.636-642 |
| issn | 0197-3851 1097-0223 |
| language | eng |
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| source | Wiley-Blackwell Journals; MEDLINE |
| subjects | Correlation analysis Female Fetal Growth Retardation - diagnostic imaging Fetal Weight Fetuses Gestational Age Humans Longitudinal Studies Nomograms Pregnancy Pregnancy, Twin Prospective Studies Thickness Twins Twins, Dizygotic Twins, Monozygotic Ultrasonography, Prenatal Umbilical Arteries - diagnostic imaging Umbilical cord Umbilical Cord - diagnostic imaging Umbilical vein |
| title | Sonographic evaluation of umbilical cord thickness in monochorionic diamniotic twin pregnancies |
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