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- W2001100850 abstract "To determine the clinical significance of abnormal placental cord insertion (PCI) in monochorionic-diamniotic (MCDA) twins. A retrospective cohort study of MCDA twins evaluated in a single center from July 2008 and June 2010. PCI and pregnancy outcomes including fetal demise of one or both twins, twin-twin-transfusion syndrome (TTTS), and unequal placental sharing (UPS) with discordant twin growth of ≥20% at birth were assessed. Outcomes of MCDA twins with normal PCI (central & eccentric) were compared to those with abnormal PCI (marginal & velamentous) and to velamentous PCI alone affecting one or both twins. Statistical analysis was performed using Fisher's exact test, with p<0.05 considered significant. Over the 2-year period, 123 MCDA pregnancies were evaluated by ultrasound with known outcomes in 84 (68.3%). Of these 84 cases, the PCI was determined for both fetuses in 77 pregnancies (91.7%) at a mean gestational age of 19 weeks (range 12-27 6/7). Of the 77 MCDA pregnancies, two live births occurred in 61 cases (79.2%), one live birth in 6 cases (7.8%), and no live births in 10 cases (13.0%). Twenty-five cases (32.3%) were diagnosed with TTTS, and birth weight data was available in 44 of the remaining 52 (84.6%). Stratified by PCI, rates of fetal loss, TTTS, and UPS were as shown in the following table.Tabled 1Outcome variableNormal PCI in both twinsAbnormal PCI in one or both twinsNormal vs abnormal PCIVelamentous PCI in one twin⁎No cases of velamentous in both twinsNormal vs velamentous PCIn=34n=43pn=23pFetal demise of one or both twins4 (11.8%)12 (27.9%)0.0987 (30.4%)0.098TTTS5 (14.7%)20 (46.5%)0.00313 (56.5%)0.001UPS2/26 (7.7%)8/18 (44.4%)0.0085/7 (71.4%)<0.002 No cases of velamentous in both twins Open table in a new tab Abnormal PCI, particularly velamentous, is strongly associated with TTTS and UPS in MCDA twins. Routine PCI determination may help identify MCDA twins that warrant increased sonographic surveillance for complications and adverse outcomes." @default.
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- W2001100850 date "2011-01-01" @default.
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- W2001100850 title "358: Abnormal placental cord insertion in monochorionic-diamniotic twins: an ominous finding" @default.
- W2001100850 doi "https://doi.org/10.1016/j.ajog.2010.10.376" @default.
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