First-Trimester sonographic prediction of obstetric and neonatal outcomes in monochorionic diamniotic twin pregnancies

M. Baraa Allaf, Anthony M. Vintzileos, Martin R. Chavez, Joseph A. Wax, Samadh F. Ravangard, Reinaldo Figueroa, Adam Borgida, Amir Shamshirsaz, Glenn Markenson, Sarah Davis, Rebecca Habenicht, Sina Haeri, Ali Ozhand, Jeffery Johnson, Haleh Sangi-Haghpeykar, Melissa Spiel, Rodrigo Ruano, Marjorie Meyer, Michael A. Belfort, Paul OgburnWinston A. Campbell, Alireza A. Shamshirsaz

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Objectives-The purpose of this study was to investigate whether discordant nuchal translucency and crown-rump length measurements in monochorionic diamniotic twins are predictive of adverse obstetric and neonatal outcomes. Methods-We conducted a multicenter retrospective cohort study including all monochorionic diamniotic twin pregnancies with two live fetuses at the 11-week to 13-week 6-day sonographic examination who had serial follow-up sonography until delivery. Isolated nuchal translucency, crown-rump length, and combined discordances were correlated with adverse obstetric outcomes, individually and in composite, including the occurrence of 1 or more of the following in either fetus: intrauterine growth restriction (IUGR), twin-twin transfusion syndrome (TTTS), intrauterine fetal death (IUFD), growth discordance (≥20%), and preterm birth before 28 weeks' gestation. Correlationswith adverse composite neonatal outcomes were also studied. A receiver operating characteristic curve analysis and a logistic regression analysis with a generalized estimating equation were conducted. Results-Fifty-four of the 177 pregnancies included (31%) had an adverse composite obstetric outcome, with TTTS in 19 (11%), IUGR in 21 (12%), discordant growth in 14 (8%), IUFD in 14 (8%), and preterm birth before 28 weeks in 10 (6%). Of the 254 neonates included in the study, 69 (27%) were complicated by adverse composite neonatal outcomes, with respiratory distress syndrome being the most common (n = 59 [23%]). The areas under the curve for the combined discordances to predict composite obstetric and neonatal outcomes were 0.62 (95% confidence interval, 0.52-0.72), and 0.54 (95% confidence interval, 0.46-0.61), respectively. Conclusions-In our population, nuchal translucency, crown-rump length, and combined discordances in monochorionic diamniotic twin pregnancies were not predictive of adverse composite obstetric and neonatal outcomes.

Original languageEnglish (US)
Pages (from-to)135-140
Number of pages6
JournalJournal of Ultrasound in Medicine
Volume33
Issue number1
DOIs
StatePublished - Jan 1 2014

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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