The comparison of the perinatal outcomes in monochorionic twin pregnancies with and without selective intrauterine growth restriction

Fide Pişirgen E., Akalın M., Demrici O., Kumru P., Akalın E. E.

Perinatal Journal, cilt.29, sa.1, ss.20-26, 2021 (Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 29 Sayı: 1
  • Basım Tarihi: 2021
  • Doi Numarası: 10.2399/prn.21.0291004
  • Dergi Adı: Perinatal Journal
  • Derginin Tarandığı İndeksler: Scopus
  • Sayfa Sayıları: ss.20-26
  • Marmara Üniversitesi Adresli: Hayır

Özet

Objective: Both fetuses may be affected negatively as a result of the

non-equal share of the placenta and vascular anastomoses in monochorionic

pregnancies with selective intrauterine growth restriction

(sIUGR). In our study, we aimed to investigate the perinatal outcomes

of both larger and smaller fetuses in monochorionic pregnancies

with and without sIUGR (non-sIUGR) separately.

Methods: A total of 196 monochorionic twin pregnancies were evaluated

retrospectively between January 2013 and January 2019. The

cases were grouped as sIUGR and non-sIUGR pregnancies. The

pregnancies with sIUGR were also separated into sub-groups as the

cases with normal umbilical flow pattern and the cases with abnormal

umbilical flow pattern. The perinatal outcomes were investigated

separately between the groups for larger and smaller fetuses.

Results: Of 153 monochorionic pregnancies included in the study,

17.6% (n=27) were sIUGR cases and 82.4% (n=126) were nonsIUGR

cases. While the umbilical artery flow pattern was normal in

59.3% (n=16) of the pregnancies which developed sIUGR, 40.7%

(n=11) of them had abnormal umbilical artery flow pattern. The

preeclampsia rate was found significantly higher in sIUGR pregnancies

than non-sIUGR pregnancies (25.9% vs. 11.1%, p=0.042). The

need for intensive care for both larger and smaller newborns was significantly

higher in sIUGR pregnancies compared to non-sIUGR

pregnancies (p<0.001). Three (11.1%) of newborns in sIUGR pregnancies

passed away during neonatal period. All of the newborns that

passed away were the smaller newborns from sIUGR pregnancies

with abnormal umbilical artery flow pattern.

Conclusion: The pregnancies with selective intrauterine growth

restriction (sIUGR) are more associated with high risks in terms of perinatal

outcomes compared to the pregnancies with non-sIUGR. In pregnancies

developing sIUGR, the risk increases for larger fetus as well as

smaller fetus. More prospective studies are needed to investigate

whether this increased risk in the pregnancies with sIUGR is associated

with prematurity which is more common or is a result of sIUGR.