Startseite Medizin First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies
Artikel
Lizenziert
Nicht lizenziert Erfordert eine Authentifizierung

First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies

  • Tanya Maric , Natasha Singh , Keith Duncan , Guy J. Thorpe-Beeston und Makrina D. Savvidou EMAIL logo
Veröffentlicht/Copyright: 25. März 2014
Journal of Perinatal Medicine
Aus der Zeitschrift Journal of Perinatal Medicine Band 43 Heft 6

Abstract

Objective: To investigate the relation between first-trimester fetal growth discrepancy, as assessed by crown-rump length (CRL) at 11+0 to 13+6 weeks of gestation, and subsequent development of preeclampsia (PE) in dichorionic diamniotic (DCDA) twin pregnancies. The association between inter-twin CRL and birth weight (BW) discrepancy was also investigated.

Methods: This was a retrospective, case-control study of DCDA twin pregnancies. Inter-twin CRL discrepancy was calculated as 100×(larger CRL–smaller CRL)/larger CRL. BW discordance was calculated as 100×(larger BW–smaller BW)/larger BW.

Results: The study included 299 DCDA pregnancies that remained normotensive and 35 that subsequently developed PE. There was no significant difference in the inter-twin CRL discrepancy between pregnancies complicated by PE and those that were not [3.2%, interquartile range (IQR): 0.5–4.5% vs. 3.3%, IQR: 1.4–5.5%; P=0.17]. There was a positive correlation between inter-twin CRL and BW discrepancy but only in pregnancies that remained normotensive (P<0.001). In women that subsequently developed PE, there was no association between inter-twin CRL and BW discordance (P=0.54).

Conclusions: In unselected DCDA twins, first-trimester CRL discrepancy is not different between pregnancies that subsequently develop PE and those that remain normotensive. Furthermore, in pregnancies that are complicated by PE, the association between inter-twin CRL and BW discrepancy appears to be lost.

Keywords: Crown-rump length discordance; dichorionic diamniotic twins; first trimester; preeclampsia
Corresponding author: Dr. Makrina D. Savvidou, Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK, Tel.: 0044 20 8846 7892, Fax: 0044 20 8846 7796, E-mail:

References

[1] Achiron R, Blickstein I. Persistent discordant twin growth following IVF-ET. Acta Genet Med Gemellol. 1993;42:41–4.10.1017/S051528360004227XSuche in Google Scholar

[2] Bhide A, Sankaran S, Sairam S, Papageorghiou AT, Thilaganathan B. Relationship of intertwin crown-rump length discrepancy to chorionicity, fetal demise and birth-weight discordance. Ultrasound Obstet Gynecol. 2009;34:131–5.10.1002/uog.6396Suche in Google Scholar

[3] Blickstein I, Goldman RD. Inter-twin birth weight discordance as a potential adaptive measure to promote gestational age. J Reprod Med. 2003;48:449–54.Suche in Google Scholar

[4] Blickstein I, Lancet M. The growth discordant twin. Obstet Gynecol Surv. 1988;43:509–15.10.1097/00006254-198809000-00002Suche in Google Scholar

[5] Blickstein I, Goldman RD, Mazkereth R. Adaptive growth restriction as a pattern of birth weight discordance in twin gestations. Obstet Gynecol. 2000;96:986–90.10.1097/00006250-200012000-00022Suche in Google Scholar

[6] Bulfin MJ, Lawler PE. Problems associated with toxemia in twin pregnancies. Am J Obstet Gynecol. 1957;73:37–42.10.1016/S0002-9378(16)37264-7Suche in Google Scholar

[7] Cheung VYT, Bocking AD, Dasilva OP. Preterm discordant twins: what birth weight difference is significant? Obstet Gynecol. 1995;172:955–9.10.1016/0002-9378(95)90027-6Suche in Google Scholar

[8] Coonrod DV, Hickok DE, Zhu K, Easterling TR, Daling JR. Risk factors for preeclampsia in twin pregnancies: a population-based cohort study. Obstet Gynecol. 1995;85:645–50.10.1016/0029-7844(95)00049-WSuche in Google Scholar

[9] Cooperstock MS, Tummaro R, Bakewell J, Schramm W. Twin birth weight discordance and risk of preterm birth. Am J Obstet Gynecol. 2000;183:63–7.10.1016/S0002-9378(00)55604-XSuche in Google Scholar

[10] D’Antonio F, Khalil A, Dias T, Thilaganathan B; Southwest Thames Obstetric Research Collaborative (STORK). Weight discordance and perinatal mortality in twins: analysis of the Southwest Thames Obstetric Research Collaborative (STORK) multiple pregnancy cohort. Ultrasound Obstet Gynecol. 2013;41:643–8.10.1002/uog.12412Suche in Google Scholar

[11] Davey DA, MacGillivray I. The classification and definition of the hypertensive disorders of pregnancy. Am J Obstet Gynecol. 1988;158:892–8.10.1016/0002-9378(88)90090-7Suche in Google Scholar

[12] Demissie K, Ananth CV, Martin J, Hanley ML, MacDorman MF, Rhoads GG. Fetal and neonatal mortality among twin gestations in the United States: the role of intrapair birth weight discordance. Obstet Gynecol. 2002;100:474–80.10.1097/00006250-200209000-00013Suche in Google Scholar

[13] Dickey RP, Gasser RF. Ultrasound evidence for variability in the size and development of normal human embryos before the tenth post-insemination week after assisted reproductive technologies. Hum Reprod. 1993;8:331–7.10.1093/oxfordjournals.humrep.a138046Suche in Google Scholar

[14] Fareeduddin R, Williams J 3rd, Solt I, Mirocha JM, Kim MJ, Rotmensch S. Discordance of first-trimester crown-rump length is a predictor of adverse outcomes in structurally normal euploid dichorionic twins. J Ultrasound Med. 2010;29:1439–43.10.7863/jum.2010.29.10.1439Suche in Google Scholar

[15] González-Quintero VH, Luke B, O’Sullivan MJ, Misiunas R, Anderson E, Nugent C, et al. Antenatal factors associated with significant birth weight discordancy in twin gestations. Am J Obstet Gynecol. 2003;189:813–7.10.1067/S0002-9378(03)00658-6Suche in Google Scholar

[16] Granger JP, Alexander BT, Llinas MT, Bennett WA, Khalil RA. Pathophysiology of preeclampsia: linking placental ischemia/hypoxia with microvascular dysfunction. Microcirculation. 2002;9:147–60.10.1038/sj.mn.7800137Suche in Google Scholar

[17] Harper LM, Roehl KA, Odibo AO, Cahill AG. First-trimester growth discordance and adverse pregnancy outcome in dichorionic twins. Ultrasound Obstet Gynecol. 2013;41:627–31.10.1002/uog.11225Suche in Google Scholar

[18] Hollier LM, McIntire DD, Leveno KJ. Outcome of twin pregnancies according to intrapair birth weight differences. Obstet Gynecol. 1999;94:1006–10.10.1097/00006250-199912000-00019Suche in Google Scholar

[19] Isada NB, Sorokin Y, Drugan A, Johnson MP, Zador I, Evans MI. First trimester interfetal size variation in well-dated multifetal pregnancies. Fetal Diagn Ther. 1992;7:82–6.10.1159/000263654Suche in Google Scholar

[20] Kagan KO, Gazzoni A, Sepulveda-Gonzalez G, Sotiriadis A, Nicolaides KH. Discordance in nuchal translucency thickness in the prediction of severe twin-to-twin transfusion syndrome. Ultrasound Obstet Gynecol. 2007;29:527–32.10.1002/uog.4006Suche in Google Scholar

[21] Kalish RB, Chasen ST, Gupta M, Sharma G, Perni SC, Chervenak FA. First trimester prediction of growth discordance in twin gestations. Am J Obstet Gynecol. 2003;189:706–9.10.1067/S0002-9378(03)00714-2Suche in Google Scholar

[22] Kalish RB, Gupta M, Perni SC, Berman S, Chasen ST. Clinical significance of first trimester crown-rump length disparity in dichorionic twin gestations. Am J Obstet Gynecol. 2004;191:1437–40.10.1016/j.ajog.2004.06.101Suche in Google Scholar PubMed

[23] McFarlane A, Scott JS. Pre-eclampsia/eclampsia in twin pregnancies. J Med Genet. 1976;13:208–11.10.1136/jmg.13.3.208Suche in Google Scholar PubMed PubMed Central

[24] Sannoh S, Demissie K, Balasubramanian B, Rhoads GG. Risk factors for intrapair birth weight discordance in twins. Arch Gynecol Obstet. 2003;269:33–6.10.1080/jmf.13.4.230.236Suche in Google Scholar PubMed

[25] Sepulveda W, Sebire NJ, Hughes K, Odibo A, Nicolaides KH. The lambda sign at 10-14 weeks of gestation as a predictor of chorionicity in twin pregnancies. Ultrasound Obstet Gynecol. 1996;7:421–3.10.1046/j.1469-0705.1996.07060421.xSuche in Google Scholar PubMed

[26] Smith GC, Smith MF, McNay MB, Fleming JE. First-trimester growth and the risk of low birth weight. N Engl J Med. 1998;339:1817–22.10.1056/NEJM199812173392504Suche in Google Scholar PubMed

The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2013-9-22
Accepted: 2014-2-27
Published Online: 2014-3-25
Published in Print: 2015-11-1

©2015 by De Gruyter

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. Maternal risk: assessment and management
  4. Original articles – Obstetrics
  5. Ebola virus screening during pregnancy in West Africa: unintended consequences
  6. Strain at the internal cervical os assessed with quasi-static elastography is associated with the risk of spontaneous preterm delivery at ≤34 weeks of gestation
  7. Can routine laboratory parameters predict adverse pregnancy outcomes in intrahepatic cholestasis of pregnancy?
  8. Pulmonary edema in pregnancy and the puerperium: a cohort study of 53 cases
  9. Incidence and outcomes of women with Hodgkin’s lymphoma in pregnancy: a population-based study on 7.9 million births
  10. Differential utilization of expanded genetic screening tests in patients of reproductive ages from private and academic practices
  11. Association of maternal blood pressure in pregnancy with blood pressure of their offspring through adolescence
  12. Oxytocin utilization for labor induction in obese and lean women
  13. Breech delivery in the all fours position: a prospective observational comparative study with classic assistance
  14. Position at birth as an important factor for the occurrence of anal sphincter tears: a retrospective cohort study
  15. Emergency peripartum hysterectomy and risk factors by mode of delivery and obstetric history: a 10-year review from Helsinki University Central Hospital
  16. Delivery outcomes after day and night onset of labour
  17. Original articles – Fetus
  18. Perinatal outcome of congenital heart disease in a population with high consanguinity
  19. Complex and irregular heart rate dynamics in fetuses compromised by maternal anemia as a high-risk pregnancy
  20. Clinical application of fetal left modified myocardial performance index in the evaluation of fetal growth restriction
  21. First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies
  22. Original articles – Newborn
  23. Neonatal outcome in pregnant patients with antiphospholipid syndrome
  24. A longitudinal study of brainstem auditory response from birth to late term in late preterm babies and abnormal findings in high-risk babies
  25. Suctioning habits in the delivery room and the influence on postnatal adaptation – a video analysis
  26. Short communications
  27. Management of vasa previa during pregnancy
  28. Uterine rupture after the uterine fundal pressure maneuver
  29. Congress Calendar
  30. Congress Calendar
https://doi.org/10.1515/jpm-2013-0260
Schlagwörter für diesen Artikel
Crown-rump length discordance; dichorionic diamniotic twins; first trimester; preeclampsia

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. Maternal risk: assessment and management
  4. Original articles – Obstetrics
  5. Ebola virus screening during pregnancy in West Africa: unintended consequences
  6. Strain at the internal cervical os assessed with quasi-static elastography is associated with the risk of spontaneous preterm delivery at ≤34 weeks of gestation
  7. Can routine laboratory parameters predict adverse pregnancy outcomes in intrahepatic cholestasis of pregnancy?
  8. Pulmonary edema in pregnancy and the puerperium: a cohort study of 53 cases
  9. Incidence and outcomes of women with Hodgkin’s lymphoma in pregnancy: a population-based study on 7.9 million births
  10. Differential utilization of expanded genetic screening tests in patients of reproductive ages from private and academic practices
  11. Association of maternal blood pressure in pregnancy with blood pressure of their offspring through adolescence
  12. Oxytocin utilization for labor induction in obese and lean women
  13. Breech delivery in the all fours position: a prospective observational comparative study with classic assistance
  14. Position at birth as an important factor for the occurrence of anal sphincter tears: a retrospective cohort study
  15. Emergency peripartum hysterectomy and risk factors by mode of delivery and obstetric history: a 10-year review from Helsinki University Central Hospital
  16. Delivery outcomes after day and night onset of labour
  17. Original articles – Fetus
  18. Perinatal outcome of congenital heart disease in a population with high consanguinity
  19. Complex and irregular heart rate dynamics in fetuses compromised by maternal anemia as a high-risk pregnancy
  20. Clinical application of fetal left modified myocardial performance index in the evaluation of fetal growth restriction
  21. First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies
  22. Original articles – Newborn
  23. Neonatal outcome in pregnant patients with antiphospholipid syndrome
  24. A longitudinal study of brainstem auditory response from birth to late term in late preterm babies and abnormal findings in high-risk babies
  25. Suctioning habits in the delivery room and the influence on postnatal adaptation – a video analysis
  26. Short communications
  27. Management of vasa previa during pregnancy
  28. Uterine rupture after the uterine fundal pressure maneuver
  29. Congress Calendar
  30. Congress Calendar
Jetzt anmelden und 20% sparen
Institutioneller Zugang
Wie funktioniert Authentifizierung?
Haben Sie eine Idee, wie wir unsere Website verbessern können?
Bitte schreiben Sie uns.
© 2025 De Gruyter Brill
Heruntergeladen am 31.12.2025 von https://www.degruyterbrill.com/document/doi/10.1515/jpm-2013-0260/html
Button zum nach oben scrollen