Literature DB >> 25052857

Fetal growth reference ranges in twin pregnancy: analysis of the Southwest Thames Obstetric Research Collaborative (STORK) multiple pregnancy cohort.

O T Stirrup1, A Khalil, F D'Antonio, B Thilaganathan.   

Abstract

OBJECTIVE: To generate reference charts for expected fetal growth in dichorionic diamniotic (DCDA) and monochorionic diamniotic (MCDA) twin pregnancies and to compare these with those from singleton pregnancies.
METHODS: This was a retrospective study of biometric measurements from serial ultrasound examinations of twin pregnancies in the second and third trimesters, from 14 weeks' gestation to term, collected by nine hospitals over a 10-year period. The measurements obtained in each fetus at each examination included head circumference (HC), biparietal diameter (BPD), abdominal circumference (AC) and femur length (FL). Multilevel mixed effects statistical models were used to evaluate growth in each biometric variable in relation to gestational age, taking account of the serial examinations and the association between the two fetuses in each pregnancy, with separate models constructed for DCDA and MCDA pregnancies.
RESULTS: The final dataset for analysis included a total of 9866 second- and third-trimester ultrasound examinations in 1802 DCDA and 323 MCDA twin pregnancies, with a median of five (range, 1-14) scans per pregnancy. For each variable, the mean value for DCDA twins was close to the reported value in singletons at 20-30 weeks and showed a decrease relative to singletons beyond 30 weeks. The differences were greater for AC and HC, for which the mean in twins was approximately equivalent to the 30th percentile in singletons at 18 weeks, the 35th percentile at 25 weeks and the 30th percentile at 35 weeks. Fetuses in MCDA twin pregnancies displayed lower mean measurements than did those in DCDA pregnancies throughout the gestational age range considered.
CONCLUSIONS: Ultrasound biometry shows a small but statistically significant reduction in fetal growth in twin pregnancies relative to that in singletons, particularly in the third trimester, with a more marked difference for MCDA than for DCDA pregnancies.
Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

Entities:  

Keywords:  dichorionic diamniotic; fetal growth; monochorionic diamniotic; multiple pregnancy; twin pregnancy; ultrasound

Mesh:

Year:  2014        PMID: 25052857     DOI: 10.1002/uog.14640

Source DB:  PubMed          Journal:  Ultrasound Obstet Gynecol        ISSN: 0960-7692            Impact factor:   7.299


  15 in total

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Authors:  John Allotey; Kym Ie Snell; Melanie Smuk; Richard Hooper; Claire L Chan; Asif Ahmed; Lucy C Chappell; Peter von Dadelszen; Julie Dodds; Marcus Green; Louise Kenny; Asma Khalil; Khalid S Khan; Ben W Mol; Jenny Myers; Lucilla Poston; Basky Thilaganathan; Anne C Staff; Gordon Cs Smith; Wessel Ganzevoort; Hannele Laivuori; Anthony O Odibo; Javier A Ramírez; John Kingdom; George Daskalakis; Diane Farrar; Ahmet A Baschat; Paul T Seed; Federico Prefumo; Fabricio da Silva Costa; Henk Groen; Francois Audibert; Jacques Masse; Ragnhild B Skråstad; Kjell Å Salvesen; Camilla Haavaldsen; Chie Nagata; Alice R Rumbold; Seppo Heinonen; Lisa M Askie; Luc Jm Smits; Christina A Vinter; Per M Magnus; Kajantie Eero; Pia M Villa; Anne K Jenum; Louise B Andersen; Jane E Norman; Akihide Ohkuchi; Anne Eskild; Sohinee Bhattacharya; Fionnuala M McAuliffe; Alberto Galindo; Ignacio Herraiz; Lionel Carbillon; Kerstin Klipstein-Grobusch; SeonAe Yeo; Helena J Teede; Joyce L Browne; Karel Gm Moons; Richard D Riley; Shakila Thangaratinam
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5.  Predictive Accuracy of Singleton Versus Customized Twin Growth Chart for Adverse Perinatal Outcome: A Cohort Study.

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7.  External validation of prognostic models predicting pre-eclampsia: individual participant data meta-analysis.

Authors:  Kym I E Snell; John Allotey; Melanie Smuk; Richard Hooper; Claire Chan; Asif Ahmed; Lucy C Chappell; Peter Von Dadelszen; Marcus Green; Louise Kenny; Asma Khalil; Khalid S Khan; Ben W Mol; Jenny Myers; Lucilla Poston; Basky Thilaganathan; Anne C Staff; Gordon C S Smith; Wessel Ganzevoort; Hannele Laivuori; Anthony O Odibo; Javier Arenas Ramírez; John Kingdom; George Daskalakis; Diane Farrar; Ahmet A Baschat; Paul T Seed; Federico Prefumo; Fabricio da Silva Costa; Henk Groen; Francois Audibert; Jacques Masse; Ragnhild B Skråstad; Kjell Å Salvesen; Camilla Haavaldsen; Chie Nagata; Alice R Rumbold; Seppo Heinonen; Lisa M Askie; Luc J M Smits; Christina A Vinter; Per Magnus; Kajantie Eero; Pia M Villa; Anne K Jenum; Louise B Andersen; Jane E Norman; Akihide Ohkuchi; Anne Eskild; Sohinee Bhattacharya; Fionnuala M McAuliffe; Alberto Galindo; Ignacio Herraiz; Lionel Carbillon; Kerstin Klipstein-Grobusch; Seon Ae Yeo; Joyce L Browne; Karel G M Moons; Richard D Riley; Shakila Thangaratinam
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