Tullio Ghi1, Federico Prefumo2, Anna Fichera2, Mariano Lanna3, Enrico Periti4, Nicola Persico5, Elsa Viora6, Giuseppe Rizzo7. 1. Department of Obstetrics and Gynecology, University of Parma, Italy. 2. Department of Obstetrics and Gynecology, University of Brescia, Italy. 3. Department of Obstetrics and Gynecology, University of Milan, Buzzi Children's Hospita, Italy. 4. Department of Obstetrics and Gynecology, Presidio Ospedaliero Centro Piero Palagi, Firenze, Italy. 5. Department of Obstetrics and Gynecology, L. Mangiagalli, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy. 6. Department of Obstetrics and Gynecology, Ospedale Sant'Anna, Turin, Italy. 7. Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy. Electronic address: giuseppe.rizzo@uniroma2.it.
Abstract
BACKGROUND: Twin gestations are at significantly higher risk of fetal growth restriction in comparison with singletons. Using fetal biometric charts customized for obstetrical and parental characteristics may facilitate an accurate assessment of fetal growth. OBJECTIVE: The objective of the study was to construct reference charts for the gestation of fetal biometric parameters stratified by chorionicity and customized for obstetrical and parental characteristics. STUDY DESIGN: Fetal biometric measurements obtained from serial ultrasound examinations in uncomplicated twin pregnancies delivering after 36 weeks of gestation were collected by 19 Italian fetal medicine units under the auspices of the Società Italiana di Ecografia Ostetrica e Ginecologica. The measurements acquired in each fetus at each examination included biparietal diameter, head circumference, abdominal circumference, and femur length. Multilevel linear regression models were used to adjust for the serial ultrasonographic measurements obtained and the clustering of each fetus in twin pregnancy. The impact of maternal and paternal characteristics (height, weight, ethnicity), parity, fetal sex, and mode of conception was also considered. Models for each parameter were stratified by fetal chorionicity and compared with our previously constructed growth curves for singletons. RESULTS: The data set included 1781 twin pregnancies (dichorionic, n = 1289; monochorionic diamniotic, n = 492) with 8923 ultrasonographic examinations with a median of 5 (range, 2-8) observations per pregnancy in dichorionic and 6 in (range, 2-11) monochorionic pregnancies. Growth curves of twin pregnancies differed from those of singletons, and differences were more marked in monochorionic twins and during the third trimester. A significant influence of parental characteristics was found. CONCLUSION: Curves of fetal biometric measurements in twins are influenced by parental characteristics. There is a reduction in the growth rate during the third trimester. The reference limits for gestation constructed in this study may provide a useful tool for a more accurate assessment of fetal growth in twin pregnancies.
BACKGROUND: Twin gestations are at significantly higher risk of fetal growth restriction in comparison with singletons. Using fetal biometric charts customized for obstetrical and parental characteristics may facilitate an accurate assessment of fetal growth. OBJECTIVE: The objective of the study was to construct reference charts for the gestation of fetal biometric parameters stratified by chorionicity and customized for obstetrical and parental characteristics. STUDY DESIGN: Fetal biometric measurements obtained from serial ultrasound examinations in uncomplicated twin pregnancies delivering after 36 weeks of gestation were collected by 19 Italian fetal medicine units under the auspices of the Società Italiana di Ecografia Ostetrica e Ginecologica. The measurements acquired in each fetus at each examination included biparietal diameter, head circumference, abdominal circumference, and femur length. Multilevel linear regression models were used to adjust for the serial ultrasonographic measurements obtained and the clustering of each fetus in twin pregnancy. The impact of maternal and paternal characteristics (height, weight, ethnicity), parity, fetal sex, and mode of conception was also considered. Models for each parameter were stratified by fetal chorionicity and compared with our previously constructed growth curves for singletons. RESULTS: The data set included 1781 twin pregnancies (dichorionic, n = 1289; monochorionic diamniotic, n = 492) with 8923 ultrasonographic examinations with a median of 5 (range, 2-8) observations per pregnancy in dichorionic and 6 in (range, 2-11) monochorionic pregnancies. Growth curves of twin pregnancies differed from those of singletons, and differences were more marked in monochorionic twins and during the third trimester. A significant influence of parental characteristics was found. CONCLUSION: Curves of fetal biometric measurements in twins are influenced by parental characteristics. There is a reduction in the growth rate during the third trimester. The reference limits for gestation constructed in this study may provide a useful tool for a more accurate assessment of fetal growth in twin pregnancies.
Authors: M Segev; B Djurabayev; E Hadi; Y Yinon; S Rabinowicz; C Hoffmann; S Shrot Journal: AJNR Am J Neuroradiol Date: 2022-03-24 Impact factor: 3.825
Authors: Urszula Nowacka; Katarzyna Kosińska-Kaczyńska; Paweł Krajewski; Aleksandra Saletra-Bielińska; Izabela Walasik; Iwona Szymusik Journal: Int J Environ Res Public Health Date: 2021-02-19 Impact factor: 3.390
Authors: Melissa M Amyx; Paul S Albert; Alaina M Bever; Stefanie N Hinkle; John Owen; William A Grobman; Roger B Newman; Edward K Chien; Robert E Gore-Langton; Germaine M Buck Louis; Katherine L Grantz Journal: Paediatr Perinat Epidemiol Date: 2019-09-03 Impact factor: 3.103