Intrauterine growth restriction in monochorionic-diamniotictwins

Revista da Associação Médica Brasileira

Rita De Cássia Alam Machado¹  Maria De Lourdes Brizot¹  Seizo Miyadahira¹  Rossana Pulcineli Vieira Francisco¹  Vera Lúcia Jornada Krebs¹  Marcelo Zugaib¹ 

关键词: monozygotic twins;    disease in twins;    fetal growth retardation;    laser Doppler flowmetry;    morbidity;    newborn infant;    gêmeos monozigóticos;    doenças em gêmeos;    retardo do crescimento fetal;    fluxometria por laser Doppler;    morbidade;    recém-nascido;   

DOI  :  10.1590/1806-9282.60.06.019

来源: SciELO

【 摘 要 】

Objective:to evaluate neonatal morbidity and mortality in monochorionic- -diamniotic (MCDA) twin pregnancies complicated by selective intrauterine growth restriction (sIUGR) and non-selective intrauterine growth resctriction (nsIUGR).Methods:neonatal morbidity parameters and mortality were analyzed in 34 twins with IUGR (< 10th percentile on twins’ growth charts): 18 with sIUGR and 16 with nsIUGR. The sIUGR group was made up of 18 pregnancies in which growth was restricted in only one fetus (n = 18). The nsIUGR group was composed of 8 pregnancies in which both fetuses presented restricted growth (n = 16). Cases of twin-to-twin transfusion syndrome and fetal malformation were not included in the study.Results:the MCDA twin pregnancies with sIUGR had a higher rate of orotracheal intubation (p = 0.001) and mechanical ventilation (p = 0.0006), as well as longer than average fasting time (p = 0.014) compared to those in which the fetuses had nsIUGR. A higher incidence was also observed of types II and III umbilical artery Doppler velocimetry patterns in the sIUGR cases (p = 0.002). There was no significant difference between the two groups as to mortality during pregnancy and the neonatal period (p = 0.09).Conclusion:in MCDA twin pregnancies, sIUGR presents more severe umbilical artery Doppler velocimetry abnormalities and worse morbidity than nsIUGR.

【 授权许可】

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