Prenatal assessment of fetal growth during a multiple pregnancy according to the type of placentation


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Abstract

Growth restriction of one or both fetuses during a multiple pregnancy is one of the main causes of perinatal losses. The development of specialized normative scales for estimated fetal weight for monochorionic and dichorionic twins will be able to diagnose more accurately this pregnancy complication. Objective. To assess the features of fetal growth during a multiple pregnancy according to the type of chorionicity and to develop normative scales for estimated fetal weight. Material and methods. A total of 578 uncomplicated multiple pregnancies (128 with monochorionic and 450 with dichorionic twins delivered after 34 weeks’ gestation, who underwent echographic studies and calculation of estimated fetal weight. Results. A total of 1,156 fetuses underwent 5,286fetometric studies. Regardless of chorionicity, the twin fetal growth trend is not linear - there is weight gain acceleration, starting in the second trimester, which lasts until the end of pregnancy. The mean fetal weight in dichorionic twins was higher than that for monochorionic twins, beginning at 30 weeks’ gestation. Conclusion. The developed normative scales and percentiles charts of estimated weight for different types of placentation will contribute to the improved prenatal assessment of fetal growth in a multiple pregnancy. The revealed difference in fetal growth in uncomplicated mono- and dichorionic twins will be able to reduce the false-positive rate for the diagnosis of selective growth retardation syndrome.

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About the authors

Kirill V. Kostyukov

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: kostyukov_k@yahoo.com
MD, Ph.D., Senior Researcher, Department of Fetal Medicine, Institute of Obstetrics, Doctor of Functional and Ultrasound Diagnostics, Department of Visual Diagnostics

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