Outcome prediction in monochorionic diamniotic twin pregnancies with moderately discordant amniotic fluid
Objective The aim of this study was to identify predictors of twin‐to‐twin transfusion syndrome (TTTS) and selective intrauterine growth restriction (sIUGR) in monochorionic diamniotic (MCDA) twin pregnancies with moderate amniotic fluid discordance (mAFD). Methods Monochorionic twins with mAFD (n =...
Gespeichert in:
| Veröffentlicht in: | Ultrasound in obstetrics & gynecology 2011-01, Vol.37 (1), p.15-21 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 21 |
|---|---|
| container_issue | 1 |
| container_start_page | 15 |
| container_title | Ultrasound in obstetrics & gynecology |
| container_volume | 37 |
| creator | Van Mieghem, T. Eixarch, E. Gucciardo, L. Done, E. Gonzales, I. Van Schoubroeck, D. Lewi, L. Gratacos, E. Deprest, J. |
| description | Objective
The aim of this study was to identify predictors of twin‐to‐twin transfusion syndrome (TTTS) and selective intrauterine growth restriction (sIUGR) in monochorionic diamniotic (MCDA) twin pregnancies with moderate amniotic fluid discordance (mAFD).
Methods
Monochorionic twins with mAFD (n = 45; gestational age, 15–29 weeks) were assessed for extent of fluid discordance, fetal growth discordance and fetal cardiac dysfunction, and were followed longitudinally. A prediction algorithm was constructed for TTTS and sIUGR and validated in an unrelated cohort (n = 52).
Results
Cardiac dysfunction could not predict TTTS or sIUGR. Twins below 20 weeks of gestation with a fluid discordance of ≥ 3.1 cm had a risk of TTTS of 85.7%. Sensitivity for TTTS was nevertheless only 55%. An intertwin weight discordance of ≥ 25% had 63% sensitivity and 76% specificity for sIUGR without TTTS.
Conclusion
The outcome of MCDA twins with mAFD remains unpredictable, yet high‐risk and low‐risk subgroups for TTTS can be identified based on severity of fluid discordance and gestational age. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. |
| doi_str_mv | 10.1002/uog.8802 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_821201035</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1017971812</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4112-fdd92e01b34322185d202d82ed106ea5ddb275e7e78741a9b1812b15a1c5120e3</originalsourceid><addsrcrecordid>eNp90cFq3DAQBmBRWppNWugTFEMp6cXJjGxZ9jGENi0E9pKcjSyNEwXb2ko2y759Z5ttAoXkJAt__sfSL8QnhDMEkOdLuDura5BvxArLqslBg3orVtBUkOuqkUfiOKUHAKjKonovjiToQpeqWAm_XmYbRso2kZy3sw9T5qdsDFOw9yHy1tvMeTNOPsz8OG_5Ldu7yUzWU8q2fr5n7iiamYYd22RDdGaas6eP-mHx7oN415sh0cfDeiJuf3y_ufyZX6-vfl1eXOe2RJR571wjCbArykJKrJWTIF0tySFUZJRzndSKNOlal2iaDmuUHSqDVqEEKk7E6WPuJobfC6W5HfmXaBjMRGFJbS2ZIRSK5bdXJQLqRu_zmX75jz6EJU58jhYV8lWqSsJzoI0hpUh9u4l-NHHHUe2-qJaLavdFMf18CFy6kdwT_NcMg68HYJI1Qx_3952eXcG18lHY5Y9u6wfavTiwvV1f_R38B-mxqWE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1517455620</pqid></control><display><type>article</type><title>Outcome prediction in monochorionic diamniotic twin pregnancies with moderately discordant amniotic fluid</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><source>Wiley Online Library Journals</source><source>EZB Electronic Journals Library</source><creator>Van Mieghem, T. ; Eixarch, E. ; Gucciardo, L. ; Done, E. ; Gonzales, I. ; Van Schoubroeck, D. ; Lewi, L. ; Gratacos, E. ; Deprest, J.</creator><creatorcontrib>Van Mieghem, T. ; Eixarch, E. ; Gucciardo, L. ; Done, E. ; Gonzales, I. ; Van Schoubroeck, D. ; Lewi, L. ; Gratacos, E. ; Deprest, J.</creatorcontrib><description>Objective
The aim of this study was to identify predictors of twin‐to‐twin transfusion syndrome (TTTS) and selective intrauterine growth restriction (sIUGR) in monochorionic diamniotic (MCDA) twin pregnancies with moderate amniotic fluid discordance (mAFD).
Methods
Monochorionic twins with mAFD (n = 45; gestational age, 15–29 weeks) were assessed for extent of fluid discordance, fetal growth discordance and fetal cardiac dysfunction, and were followed longitudinally. A prediction algorithm was constructed for TTTS and sIUGR and validated in an unrelated cohort (n = 52).
Results
Cardiac dysfunction could not predict TTTS or sIUGR. Twins below 20 weeks of gestation with a fluid discordance of ≥ 3.1 cm had a risk of TTTS of 85.7%. Sensitivity for TTTS was nevertheless only 55%. An intertwin weight discordance of ≥ 25% had 63% sensitivity and 76% specificity for sIUGR without TTTS.
Conclusion
The outcome of MCDA twins with mAFD remains unpredictable, yet high‐risk and low‐risk subgroups for TTTS can be identified based on severity of fluid discordance and gestational age. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.</description><identifier>ISSN: 0960-7692</identifier><identifier>ISSN: 1469-0705</identifier><identifier>EISSN: 1469-0705</identifier><identifier>DOI: 10.1002/uog.8802</identifier><identifier>PMID: 20737453</identifier><identifier>CODEN: UOGYFJ</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Algorithms ; Amniotic fluid ; Amniotic Fluid - diagnostic imaging ; Belgium - epidemiology ; Biological and medical sciences ; Biometry ; Birth weight ; cardiac function ; Discordance ; Diseases of mother, fetus and pregnancy ; Female ; Fetal Growth Retardation - diagnostic imaging ; Fetal Growth Retardation - epidemiology ; Fetofetal Transfusion - diagnostic imaging ; Fetofetal Transfusion - epidemiology ; Fetuses ; Gestational Age ; growth restriction ; Gynecology ; Gynecology. Andrology. Obstetrics ; Heart diseases ; Humans ; Infant, Newborn ; Male ; Medical sciences ; monochorionic twin ; Obstetrics ; prediction ; Predictive Value of Tests ; Pregnancy ; Pregnancy Outcome ; Pregnancy. Fetus. Placenta ; Prenatal development ; Prognosis ; Risk factors ; Risk groups ; Spain - epidemiology ; Transfusion ; Twins ; Twins, Monozygotic ; twin‐to‐twin transfusion syndrome ; Ultrasonography, Prenatal ; Ultrasound</subject><ispartof>Ultrasound in obstetrics & gynecology, 2011-01, Vol.37 (1), p.15-21</ispartof><rights>Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4112-fdd92e01b34322185d202d82ed106ea5ddb275e7e78741a9b1812b15a1c5120e3</citedby><cites>FETCH-LOGICAL-c4112-fdd92e01b34322185d202d82ed106ea5ddb275e7e78741a9b1812b15a1c5120e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fuog.8802$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fuog.8802$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,4010,27900,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23692821$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20737453$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Van Mieghem, T.</creatorcontrib><creatorcontrib>Eixarch, E.</creatorcontrib><creatorcontrib>Gucciardo, L.</creatorcontrib><creatorcontrib>Done, E.</creatorcontrib><creatorcontrib>Gonzales, I.</creatorcontrib><creatorcontrib>Van Schoubroeck, D.</creatorcontrib><creatorcontrib>Lewi, L.</creatorcontrib><creatorcontrib>Gratacos, E.</creatorcontrib><creatorcontrib>Deprest, J.</creatorcontrib><title>Outcome prediction in monochorionic diamniotic twin pregnancies with moderately discordant amniotic fluid</title><title>Ultrasound in obstetrics & gynecology</title><addtitle>Ultrasound Obstet Gynecol</addtitle><description>Objective
The aim of this study was to identify predictors of twin‐to‐twin transfusion syndrome (TTTS) and selective intrauterine growth restriction (sIUGR) in monochorionic diamniotic (MCDA) twin pregnancies with moderate amniotic fluid discordance (mAFD).
Methods
Monochorionic twins with mAFD (n = 45; gestational age, 15–29 weeks) were assessed for extent of fluid discordance, fetal growth discordance and fetal cardiac dysfunction, and were followed longitudinally. A prediction algorithm was constructed for TTTS and sIUGR and validated in an unrelated cohort (n = 52).
Results
Cardiac dysfunction could not predict TTTS or sIUGR. Twins below 20 weeks of gestation with a fluid discordance of ≥ 3.1 cm had a risk of TTTS of 85.7%. Sensitivity for TTTS was nevertheless only 55%. An intertwin weight discordance of ≥ 25% had 63% sensitivity and 76% specificity for sIUGR without TTTS.
Conclusion
The outcome of MCDA twins with mAFD remains unpredictable, yet high‐risk and low‐risk subgroups for TTTS can be identified based on severity of fluid discordance and gestational age. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.</description><subject>Algorithms</subject><subject>Amniotic fluid</subject><subject>Amniotic Fluid - diagnostic imaging</subject><subject>Belgium - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Biometry</subject><subject>Birth weight</subject><subject>cardiac function</subject><subject>Discordance</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Female</subject><subject>Fetal Growth Retardation - diagnostic imaging</subject><subject>Fetal Growth Retardation - epidemiology</subject><subject>Fetofetal Transfusion - diagnostic imaging</subject><subject>Fetofetal Transfusion - epidemiology</subject><subject>Fetuses</subject><subject>Gestational Age</subject><subject>growth restriction</subject><subject>Gynecology</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Heart diseases</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Medical sciences</subject><subject>monochorionic twin</subject><subject>Obstetrics</subject><subject>prediction</subject><subject>Predictive Value of Tests</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Prenatal development</subject><subject>Prognosis</subject><subject>Risk factors</subject><subject>Risk groups</subject><subject>Spain - epidemiology</subject><subject>Transfusion</subject><subject>Twins</subject><subject>Twins, Monozygotic</subject><subject>twin‐to‐twin transfusion syndrome</subject><subject>Ultrasonography, Prenatal</subject><subject>Ultrasound</subject><issn>0960-7692</issn><issn>1469-0705</issn><issn>1469-0705</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90cFq3DAQBmBRWppNWugTFEMp6cXJjGxZ9jGENi0E9pKcjSyNEwXb2ko2y759Z5ttAoXkJAt__sfSL8QnhDMEkOdLuDura5BvxArLqslBg3orVtBUkOuqkUfiOKUHAKjKonovjiToQpeqWAm_XmYbRso2kZy3sw9T5qdsDFOw9yHy1tvMeTNOPsz8OG_5Ldu7yUzWU8q2fr5n7iiamYYd22RDdGaas6eP-mHx7oN415sh0cfDeiJuf3y_ufyZX6-vfl1eXOe2RJR571wjCbArykJKrJWTIF0tySFUZJRzndSKNOlal2iaDmuUHSqDVqEEKk7E6WPuJobfC6W5HfmXaBjMRGFJbS2ZIRSK5bdXJQLqRu_zmX75jz6EJU58jhYV8lWqSsJzoI0hpUh9u4l-NHHHUe2-qJaLavdFMf18CFy6kdwT_NcMg68HYJI1Qx_3952eXcG18lHY5Y9u6wfavTiwvV1f_R38B-mxqWE</recordid><startdate>201101</startdate><enddate>201101</enddate><creator>Van Mieghem, T.</creator><creator>Eixarch, E.</creator><creator>Gucciardo, L.</creator><creator>Done, E.</creator><creator>Gonzales, I.</creator><creator>Van Schoubroeck, D.</creator><creator>Lewi, L.</creator><creator>Gratacos, E.</creator><creator>Deprest, J.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><general>Wiley Subscription Services, Inc</general><scope>IQODW</scope><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>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201101</creationdate><title>Outcome prediction in monochorionic diamniotic twin pregnancies with moderately discordant amniotic fluid</title><author>Van Mieghem, T. ; Eixarch, E. ; Gucciardo, L. ; Done, E. ; Gonzales, I. ; Van Schoubroeck, D. ; Lewi, L. ; Gratacos, E. ; Deprest, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4112-fdd92e01b34322185d202d82ed106ea5ddb275e7e78741a9b1812b15a1c5120e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Algorithms</topic><topic>Amniotic fluid</topic><topic>Amniotic Fluid - diagnostic imaging</topic><topic>Belgium - epidemiology</topic><topic>Biological and medical sciences</topic><topic>Biometry</topic><topic>Birth weight</topic><topic>cardiac function</topic><topic>Discordance</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>Female</topic><topic>Fetal Growth Retardation - diagnostic imaging</topic><topic>Fetal Growth Retardation - epidemiology</topic><topic>Fetofetal Transfusion - diagnostic imaging</topic><topic>Fetofetal Transfusion - epidemiology</topic><topic>Fetuses</topic><topic>Gestational Age</topic><topic>growth restriction</topic><topic>Gynecology</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Heart diseases</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Medical sciences</topic><topic>monochorionic twin</topic><topic>Obstetrics</topic><topic>prediction</topic><topic>Predictive Value of Tests</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Prenatal development</topic><topic>Prognosis</topic><topic>Risk factors</topic><topic>Risk groups</topic><topic>Spain - epidemiology</topic><topic>Transfusion</topic><topic>Twins</topic><topic>Twins, Monozygotic</topic><topic>twin‐to‐twin transfusion syndrome</topic><topic>Ultrasonography, Prenatal</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Van Mieghem, T.</creatorcontrib><creatorcontrib>Eixarch, E.</creatorcontrib><creatorcontrib>Gucciardo, L.</creatorcontrib><creatorcontrib>Done, E.</creatorcontrib><creatorcontrib>Gonzales, I.</creatorcontrib><creatorcontrib>Van Schoubroeck, D.</creatorcontrib><creatorcontrib>Lewi, L.</creatorcontrib><creatorcontrib>Gratacos, E.</creatorcontrib><creatorcontrib>Deprest, J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Ultrasound in obstetrics & gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Van Mieghem, T.</au><au>Eixarch, E.</au><au>Gucciardo, L.</au><au>Done, E.</au><au>Gonzales, I.</au><au>Van Schoubroeck, D.</au><au>Lewi, L.</au><au>Gratacos, E.</au><au>Deprest, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcome prediction in monochorionic diamniotic twin pregnancies with moderately discordant amniotic fluid</atitle><jtitle>Ultrasound in obstetrics & gynecology</jtitle><addtitle>Ultrasound Obstet Gynecol</addtitle><date>2011-01</date><risdate>2011</risdate><volume>37</volume><issue>1</issue><spage>15</spage><epage>21</epage><pages>15-21</pages><issn>0960-7692</issn><issn>1469-0705</issn><eissn>1469-0705</eissn><coden>UOGYFJ</coden><abstract>Objective
The aim of this study was to identify predictors of twin‐to‐twin transfusion syndrome (TTTS) and selective intrauterine growth restriction (sIUGR) in monochorionic diamniotic (MCDA) twin pregnancies with moderate amniotic fluid discordance (mAFD).
Methods
Monochorionic twins with mAFD (n = 45; gestational age, 15–29 weeks) were assessed for extent of fluid discordance, fetal growth discordance and fetal cardiac dysfunction, and were followed longitudinally. A prediction algorithm was constructed for TTTS and sIUGR and validated in an unrelated cohort (n = 52).
Results
Cardiac dysfunction could not predict TTTS or sIUGR. Twins below 20 weeks of gestation with a fluid discordance of ≥ 3.1 cm had a risk of TTTS of 85.7%. Sensitivity for TTTS was nevertheless only 55%. An intertwin weight discordance of ≥ 25% had 63% sensitivity and 76% specificity for sIUGR without TTTS.
Conclusion
The outcome of MCDA twins with mAFD remains unpredictable, yet high‐risk and low‐risk subgroups for TTTS can be identified based on severity of fluid discordance and gestational age. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>20737453</pmid><doi>10.1002/uog.8802</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0960-7692 |
| ispartof | Ultrasound in obstetrics & gynecology, 2011-01, Vol.37 (1), p.15-21 |
| issn | 0960-7692 1469-0705 1469-0705 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_821201035 |
| source | Wiley-Blackwell Journals; MEDLINE; Wiley Online Library Journals; EZB Electronic Journals Library |
| subjects | Algorithms Amniotic fluid Amniotic Fluid - diagnostic imaging Belgium - epidemiology Biological and medical sciences Biometry Birth weight cardiac function Discordance Diseases of mother, fetus and pregnancy Female Fetal Growth Retardation - diagnostic imaging Fetal Growth Retardation - epidemiology Fetofetal Transfusion - diagnostic imaging Fetofetal Transfusion - epidemiology Fetuses Gestational Age growth restriction Gynecology Gynecology. Andrology. Obstetrics Heart diseases Humans Infant, Newborn Male Medical sciences monochorionic twin Obstetrics prediction Predictive Value of Tests Pregnancy Pregnancy Outcome Pregnancy. Fetus. Placenta Prenatal development Prognosis Risk factors Risk groups Spain - epidemiology Transfusion Twins Twins, Monozygotic twin‐to‐twin transfusion syndrome Ultrasonography, Prenatal Ultrasound |
| title | Outcome prediction in monochorionic diamniotic twin pregnancies with moderately discordant amniotic fluid |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T18%3A56%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Outcome%20prediction%20in%20monochorionic%20diamniotic%20twin%20pregnancies%20with%20moderately%20discordant%20amniotic%20fluid&rft.jtitle=Ultrasound%20in%20obstetrics%20&%20gynecology&rft.au=Van%20Mieghem,%20T.&rft.date=2011-01&rft.volume=37&rft.issue=1&rft.spage=15&rft.epage=21&rft.pages=15-21&rft.issn=0960-7692&rft.eissn=1469-0705&rft.coden=UOGYFJ&rft_id=info:doi/10.1002/uog.8802&rft_dat=%3Cproquest_cross%3E1017971812%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1517455620&rft_id=info:pmid/20737453&rfr_iscdi=true |