Perinatal Outcomes in the Discordance of the Physical Development of Monochorionic Twins

Abstract

Aim: To compare perinatal outcomes in the group of monochorionic discordant twins, depending on the complications of the antenatal period. Design: Cohort retrospective study. Materials and methods. 104 pairs of discordant monochorionic twins were examined: 44 pairs with feto-fetal transfusion syndrome (TTTS) and 60 pairs with signs of selective fetal growth retardation (SSFGR). Results. In the TFFT + CVDGR group, cervical insufficiency was more common (p = 0.004), delivery before 32 weeks of gestation (OR = 4.84; 95% CI: 1.78–13.18) and there was a higher risk of extremely severe discordance (≥ 50%) (p = 0.018): OR = 4.12; 95% CI: 1.2–14.6. Severe asphyxia was recorded more often in children who underwent TTTS — 34 (38.6%) patients versus 26 (21.7%) newborns of the SSFGR group: OR = 2.36; 95% CI: 1.28–4.36, p = 0.006. An inverse correlation was determined between gestational age and the degree of discordance in the SSFGR group. Conclusion. Differences in perinatal outcomes in monochorionic diamniotic twins with discordant physical development were revealed depending on the type of specific complication of intrauterine development. Keywords: growth discordance, feto-fetal transfusion syndrome, selective fetal growth retardation syndrome