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

• Published in: SVU - International Journal of Medical Sciences
• Main Authors: Abd El-Naser Abd El-Gaber Ali, Altayeb Abd-alal Mostafa *, Mostafa Hussein, Mostafa Mohammad Khodry
• Format: Article
• Language: English
• Published: South Valley University, Faculty of Medicine 2022-07-01
• Subjects: monochorionic twin pregnancies; siugr; perinatal morbidity
• Online Access: https://svuijm.journals.ekb.eg/article_247477.html
• ISSN: 2735-427X; 2636-3402

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.