Additional benefits of three-dimensional ultrasound for prenatal assessment of twins
-
Tuangsit Wataganara
, Piengbulan Yapan
Abstract
Three-dimensional ultrasound (3DUS) may provide additional information for prenatal assessment of twins. It may improve the diagnostic confidence of dating, nuchal translucency (NT) and chorionicity assignment in twin pregnancies. The “virtual 3DUS placentoscopy” can guide selective fetoscopic laser photocoagulation (SFLP) to treat twin-twin transfusion syndrome (TTTS). Volumetric assessment of the dysmorphic acardiac twin with the Virtual Organ Computer-aided Analysis (VOCAL) software is more accurate than the conventional ultrasound measurement. Twin anemia polycythemia (TAP) sequence and selective intrauterine growth restriction (sIUGR) may be clinically monitored with 3DUS placental volume (PV) and power Doppler vascular indices. Congenital anomalies are more common in twins. Evaluation of fetal anomalies with 3DUS could assist perinatal management. The 3DUS power Doppler can provide a better understanding of true and false umbilical cord knots, which are commonly found in monoamniotic (MA) twins. Single demise in monochorionic (MC) twin pregnancies can cause severe neurologic morbidity in the surviving co-twin. Prenatal prediction of brain injury in the surviving co-twin with unremarkable neurosonographic examination is difficult. The 3DUS power Doppler may aid in prenatal detection of subtle abnormal cerebral perfusion. Prenatal assessment of conjoined twins with 3DUS is important if emergency postnatal surgical separation is anticipated. There is no significant additional advantage in using real-time 3DUS to guide prenatal interventions. Assessment of the cervix and pelvic floor during twin pregnancies is enhanced with 3DUS. Due to lack of high-quality studies, routine prenatal 3DUS in twin pregnancies needs to be balanced with risks of excessive ultrasound exposure.
Acknowledgments
The scientific content of this manuscript was presented at the 3rd World Congress on 3D/4D Ultrasound in Obstetrics and Gynecology on March 22, 2019 in Dubrovnik, Croatia. The authors want to thank Sommai Viboonchart, Nadda Mongkolchat, Suparat Jaingam, Chutima Yaiyiam and Supitchaya Surasereewong for their administrative assistance.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2020 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review
- Variations in long-term outcome reporting among offspring followed up after lifestyle interventions in pregnancy: a systematic review
- Corner of Academy
- Modifiable risk factors for spontaneous preterm birth in nulliparous women: a prospective study
- Additional benefits of three-dimensional ultrasound for prenatal assessment of twins
- Original Articles – Obstetrics
- Microbial burden and inflammasome activation in amniotic fluid of patients with preterm prelabor rupture of membranes
- Amniotic fluid concentrations of soluble endoglin and endothelial cell-specific molecule-1 in pregnancies complicated with neural tube defects
- Maternal characteristics and pregnancy outcomes of women with chronic hypertension: a population-based study
- Behavior of fetal longitudinal myocardial fibers assessed by speckle tracking to obtain strain and strain rate values for low-risk pregnancies
- The effect of a scheduled regimen of acetaminophen and ibuprofen on opioid use following cesarean delivery
- Original Articles – Fetus
- Comparison of cord blood lactate measurement by gas analyzer and portable electrochemical devices
- Perinatal mortality: epidemiological profile, causes and avoidable factors at a reference public maternity hospital in the State of Santa Catarina, Brazil, 2011–2015
- Original Articles – Newborns
- Maternal smoking and cannabis use during pregnancy and infant outcomes
- The utility of cranial ultrasound as a screening tool for neonatal ECMO
- Effects of human milk fortifier properties on intrinsic probiotic bacteria
- Letter to the Editor
- Superb microvascular imaging with Doppler luminance using an 18-MHz probe to visualize fetal intra-abdominal blood vessels and organ microvasculature
Articles in the same Issue
- Frontmatter
- Review
- Variations in long-term outcome reporting among offspring followed up after lifestyle interventions in pregnancy: a systematic review
- Corner of Academy
- Modifiable risk factors for spontaneous preterm birth in nulliparous women: a prospective study
- Additional benefits of three-dimensional ultrasound for prenatal assessment of twins
- Original Articles – Obstetrics
- Microbial burden and inflammasome activation in amniotic fluid of patients with preterm prelabor rupture of membranes
- Amniotic fluid concentrations of soluble endoglin and endothelial cell-specific molecule-1 in pregnancies complicated with neural tube defects
- Maternal characteristics and pregnancy outcomes of women with chronic hypertension: a population-based study
- Behavior of fetal longitudinal myocardial fibers assessed by speckle tracking to obtain strain and strain rate values for low-risk pregnancies
- The effect of a scheduled regimen of acetaminophen and ibuprofen on opioid use following cesarean delivery
- Original Articles – Fetus
- Comparison of cord blood lactate measurement by gas analyzer and portable electrochemical devices
- Perinatal mortality: epidemiological profile, causes and avoidable factors at a reference public maternity hospital in the State of Santa Catarina, Brazil, 2011–2015
- Original Articles – Newborns
- Maternal smoking and cannabis use during pregnancy and infant outcomes
- The utility of cranial ultrasound as a screening tool for neonatal ECMO
- Effects of human milk fortifier properties on intrinsic probiotic bacteria
- Letter to the Editor
- Superb microvascular imaging with Doppler luminance using an 18-MHz probe to visualize fetal intra-abdominal blood vessels and organ microvasculature