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dc.contributor.authorBreathnach, Fionnuala M
dc.contributor.authorMalone, Fergal D
dc.date.accessioned2012-10-30T14:53:44Z
dc.date.available2012-10-30T14:53:44Z
dc.date.issued2012-06
dc.identifier.citationFetal growth disorders in twin gestations. 2012, 36 (3):175-81 Semin. Perinatol.en_GB
dc.identifier.issn1558-075X
dc.identifier.pmid22713498
dc.identifier.doi10.1053/j.semperi.2012.02.002
dc.identifier.urihttp://hdl.handle.net/10147/250595
dc.description.abstractTwin 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.
dc.language.isoenen
dc.rightsArchived with thanks to Seminars in perinatologyen_GB
dc.subject.meshBirth Weight
dc.subject.meshFemale
dc.subject.meshFetal Development
dc.subject.meshFetal Diseases
dc.subject.meshFetal Growth Retardation
dc.subject.meshFetofetal Transfusion
dc.subject.meshGrowth Disorders
dc.subject.meshHumans
dc.subject.meshPlacental Insufficiency
dc.subject.meshPregnancy
dc.subject.meshPregnancy, Twin
dc.subject.meshUltrasonography, Prenatal
dc.titleFetal growth disorders in twin gestations.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland. fbreathnach@rcsi.ieen_GB
dc.identifier.journalSeminars in perinatologyen_GB
dc.description.provinceLeinsteren
html.description.abstractTwin 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.


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