Perinatal outcomes in twin pregnancies with discordant Doppler velocimetric findings.
Summary of "Perinatal outcomes in twin pregnancies with discordant Doppler velocimetric findings."
Objectives- The purpose of this study was to investigate whether poor perinatal outcomes are more common in twins with abnormal umbilical artery Doppler velocimetric findings than in their siblings with normal findings. Methods- A matched-pair cohort analysis of twin pregnancies with discordant umbilical artery Doppler velocimetric findings (one normal and one abnormal) was performed. Both severely abnormal findings (defined as absent or reversed flow in one twin; n = 23) and mildly abnormal findings (defined as an elevated systolic to diastolic ratio in one twin; n = 28) were included. The matched twins provided a gestational age-and demographically matched comparison group. Outcomes measured included intrauterine fetal death, oligohydramnios, intrauterine growth restriction, and neonatal outcomes (birth weight, Apgar scores, intraventricular hemorrhage, necrotizing enterocolitis, respiratory distress syndrome, bronchopulmonary dysplasia, and sepsis). Associations between abnormal Doppler velocimetric findings and perinatal outcomes were estimated using matched logistic regression analysis. Results- Among this cohort of twin pregnancies with discordant umbilical artery Doppler velocimetric findings, oligohydramnios and intrauterine growth restriction were more frequent in twin fetuses with abnormal findings. Adverse neonatal outcomes were high in both groups (57% among those with normal findings and 49% among those with abnormal findings) because of the overwhelming contribution of preterm delivery (mean gestational age at delivery, 33.3 weeks) but were not significantly different between those fetuses with abnormal findings compared to their cotwins with normal findings. Conclusions- Our results do not show an association between abnormal umbilical artery Doppler velocimetric findings and short-term adverse neonatal outcomes.
Affiliation
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, 333 Cedar St, PO Box 208063, New Haven, CT 06520-8063 USA. unzila.ali@yale.edu.
Journal Details
This article was published in the following journal.
Name: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
ISSN: 1550-9613
Pages: 1561-5
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22039029
- DOI: http://dx.doi.org/
Medical and Biotech [MESH] Definitions
Twin Studies As Topic
Methods of detecting genetic etiology in human traits. The basic premise of twin studies is that monozygotic twins, being formed by the division of a single fertilized ovum, carry identical genes, while dizygotic twins, being formed by the fertilization of two ova by two different spermatozoa, are genetically no more similar than two siblings born after separate pregnancies. (Last, J.M., A Dictionary of Epidemiology, 2d ed)
Fetofetal Transfusion
Passage of blood from one fetus to another via an arteriovenous communication or other shunt, in a monozygotic twin pregnancy. It results in anemia in one twin and polycythemia in the other. (Lee et al., Wintrobe's Clinical Hematology, 9th ed, p737-8)
Ultrasonography, Doppler, Duplex
Ultrasonography applying the Doppler effect combined with real-time imaging. The real-time image is created by rapid movement of the ultrasound beam. A powerful advantage of this technique is the ability to estimate the velocity of flow from the Doppler shift frequency.
Echocardiography, Doppler, Color
Echocardiography applying the Doppler effect, with the superposition of flow information as colors on a gray scale in a real-time image.
Perinatology
The branch of medicine dealing with the fetus and infant during the perinatal period. The perinatal period begins with the twenty-eighth week of gestation and ends twenty-eight days after birth. (From Dorland, 27th ed)
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