Predictive values of first trimester ultrasound screening for twin-to-twin transfusion syndrome and selective intrauterine growth restriction in monochorionic twin pregnancies

Ali, Abd El-Naser Abd El-Gaber; Mostafa, Altayeb Abd-alal; Hussein, Mostafa; Khodry, Mostafa Mohammad

doi:10.21608/svuijm.2022.136000.1305

Predictive values of first trimester ultrasound screening for twin-to-twin transfusion syndrome and selective intrauterine growth restriction in monochorionic twin pregnancies

Document Type : Original research articles

Authors

¹ Department of Obstetrics and Gynecology, Faculty of Medicine, South Valley University, Qena, Egypt.

² Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt.

10.21608/svuijm.2022.136000.1305

Abstract

Background: Monochorionic diamniotic (MCDA) twins have a substantially higher risk for perinatal morbidity and mortality due to the presence of placental vascular anastomoses between the twins.
Objectives: The primary purpose of this research was to confirm the accuracy of first trimester ultrasonography in predicting selective intrauterine growth restriction (SIGR) and twin-to-twin transfusion syndrome (TTTS) in monochorionic twin pregnancies using the triad of nuchal translucency (NT), cord insertion and inter-twin discordance in foetal size.
Patients and methods: This was a prospective cohort study that included 31 pregnant women who were carrying monochorionic twins during the first trimester. The research was carried out at a foetal medicine unite, Obstetrics and Gynecology Department, South Valley University Hospital. The duration of the study ranged from 18 to 24 months.
Results: the mean difference in NT can determine TTTS with fair sensitivity (73.2%) and high specificity (100%) in twins (p < 0.001). Likewise, mean difference in CRL can determine TTTS with fair sensitivity (73.1%) and high specificity (100%) in twins (p < 0.001).The mean difference in NT can determine sIUGR with high sensitivity (100%) and fair specificity (73.2%) in twins (p < 0.001). Likewise, mean difference in CRL can determine sIUGR with high sensitivity (100%) and fair specificity (73.1%) in twins (p < 0.001).
Conclusion: we have demonstrated that NT and CRL were significantly higher in TTTS group, and NT and CRL were respectively identified as the predictive markers for sIUGR and TTTS.

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