Intertwin discordance in fetal size at 11–13?weeks' gestation and pregnancy outcome

摘要

ABSTRACT Objective To investigate the value of intertwin discordance in fetal crown–rump length (CRL) at the 11–13‐week scan in the prediction of adverse outcome in dichorionic (DC), monochorionic diamniotic (MCDA) and monochorionic monoamniotic (MCMA) twin pregnancies. Methods This was a retrospective analysis of prospectively collected data on twin pregnancies undergoing routine ultrasound examination at 11–13?weeks' gestation between 2002 and 2019. In pregnancies with no major abnormalities, we examined the value of intertwin discordance in fetal CRL in DC, MCDA and MCMA twins in the prediction of fetal loss at ?20 and ?24?weeks' gestation, perinatal death at ≥?24?weeks, preterm delivery at ?32 and ?37?weeks, birth of at least one small‐for‐gestational‐age (SGA) neonate with birth weight ?5 th percentile and intertwin birth‐weight discordance of ≥?20% and ≥?25%. Results First, the study population of 6225 twin pregnancies included 4896 (78.7%) DC, 1274 (20.4%) MCDA and 55 (0.9%) MCMA twin pregnancies. Second, median CRL discordance in DC twin pregnancies (3.2%; interquartile range (IQR), 1.4–5.8%) was lower than in MCDA twins (3.6%; IQR, 1.6–6.2%; P ?=?0.0008), but was not significantly different from that in MCMA twins (2.9%; IQR, 1.2–5.1%; P Conclusions