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    Fetal growth disorders in twin gestations.

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    Authors
    Breathnach, Fionnuala M
    Malone, Fergal D
    Affiliation
    Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland. fbreathnach@rcsi.ie
    Issue Date
    2012-06
    MeSH
    Birth Weight
    Female
    Fetal Development
    Fetal Diseases
    Fetal Growth Retardation
    Fetofetal Transfusion
    Growth Disorders
    Humans
    Placental Insufficiency
    Pregnancy
    Pregnancy, Twin
    Ultrasonography, Prenatal
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    Citation
    Fetal growth disorders in twin gestations. 2012, 36 (3):175-81 Semin. Perinatol.
    Journal
    Seminars in perinatology
    URI
    http://hdl.handle.net/10147/250595
    DOI
    10.1053/j.semperi.2012.02.002
    PubMed ID
    22713498
    Abstract
    Twin growth is frequently mismatched. This review serves to explore the pathophysiologic mechanisms that underlie growth aberrations in twin gestations, the prenatal recognition of abnormal twin growth, and the critical importance of stratifying management of abnormal twin growth by chorionicity. Although poor in utero growth of both twins may reflect maternal factors resulting in global uteroplacental dysfunction, discordant twin growth may be attributed to differences in genetic potential between co-twins, placental dysfunction confined to one placenta only, or one placental territory within a shared placenta. In addition, twin-twin transfusion syndrome represents a distinct entity of which discordant growth is a common feature. Discordant growth is recognized as an independent risk factor for adverse perinatal outcome. Intertwin birth weight disparity of 18% or more should be considered to represent a discordance threshold, which serves as an independent risk factor for adverse perinatal outcome. At this cutoff, perinatal morbidity is found to increase both for the larger and the smaller twin within a discordant pair. There remains uncertainty surrounding the sonographic parameters that are most predictive of discordance. Although heightening of fetal surveillance in the face of discordant twin growth follows the principles applied to singleton gestations complicated by fetal growth restriction, the timing of intervention is largely influenced by chorionicity.
    Item Type
    Article
    Language
    en
    ISSN
    1558-075X
    ae974a485f413a2113503eed53cd6c53
    10.1053/j.semperi.2012.02.002
    Scopus Count
    Collections
    Rotunda Hospital

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