%0 Journal Article
%T Outcome of monochorionic diamniotic twin pregnancy with selective intrauterine growth restriction, a single center study in China.
%A Qiu T
%A Guo Y
%A Cheng W
%A Chen Y
%A Shen H
%A Xu L
%J Clin Imaging
%V 106
%N 0
%D 2024 Feb 23
%M 38042047
%F 2.42
%R 10.1016/j.clinimag.2023.110032
%X <B>BACKGROUND: </B>This retrospective study aimed to evaluate clinical outcomes of monochorionic diamniotic (MCDA) twins with selective intrauterine growth restriction (sIUGR).<BR><B>METHODS: </B>MCDA twins, either sIUGR and non-sIUGR, underwent expectant management from 2016 to 2019 in our hospital were included. sIUGR fetuses were classified into three types according to umbilical artery Doppler assessment. Non-sIUGR were considered as the control group. Outcomes were pregnancy outcomes and maternal complications.<BR><B>RESULTS: </B>Forty-three sIUGR (type I: 23; type II: 14, and type III: 6) and 282 non-sIUGR fetuses were included. The sIUGR group had a significantly earlier birth, lower birth weight of the twins, larger inter-twin weight difference, lower Apgar score of the twins, and higher intrauterine fetal death (IUFD) than the non-sIUGR group (all p < 0.001). The same trend was found in the sIUGR type II group compared to type I and III groups. A significantly lower gestational diabetes rate (p = 0.01) and placenta weight (p < 0.001), and higher proportions of abnormal placental umbilical cord insertion (p < 0.001), and ultrasound Doppler monitoring indicators (p = 0.006) were found in the sIUGR group than the non-sIUGR group.<BR><B>CONCLUSIONS: </B>The MCDA twins with sIUGR showed poorer outcomes than the non-sIUGR group. Doppler interrogation was a useful clinical marker for fetal outcome.