{"title":"双胞胎脐带卷绕指数的差异与双胞胎体重和多普勒指数的差异有关。","authors":"Degani, Lewinsky, Aharoni, Gonen, Ohel","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>> Objective: The aim of our study was to evaluate sonographic and Doppler detectable differences in umbilical coiling index and fetoplacental circulation of discordant twins. Study Design: Doppler blood flow studies in 13 pairs of concordant and 20 pairs of discordant twins were performed from umbilical artery, middle cerebral artery, inferior vena cava, and ductus venosus. Flow studies were compared and correlated with the antenatal sonographic coiling index and the actual umbilical cord length, number of vascular helices, and birth weight. All studies were performed within 72 h before delivery. Pulsatility index (PI) values were calculated for the arteries and preload index (PLI) values for the veins. The umbilical coiling index (CI) was calculated using sonographic longitudinal views of cord vessels from several segments antenatally and by dividing the total number of helices by cord length (cm) postnatally. Discordancy was defined as a more than 20% intrapair actual birth weight difference. For all these index values the intertwin differences (Delta values) were calculated by subtracting the values obtained in the larger twin with those of the smaller twin. Results: The mean +/- SD intertwin difference in umbilical coiling index was 27.4 +/- 10.5% in the antepartum period and 28.9 +/- 10.0% after birth. Regression analysis showed a significant linear trend (r = 0.77, P < 0.001) between intertwin birth weight difference (DeltaBW) and intertwin coiling index difference (DeltaCI). A good correlation was found between DeltaCI and DeltaPLI in the ductus venosus (r = 0.63, P < 0.05), DeltaPLI in the inferior vena cava (r = 0.51, P < 0.005), and DeltaPI in the middle cerebral artery (r = 0.44, P < 0.05). Conclusions: Intertwin difference in antepartum umbilical coiling index can be determined by ultrasound and correlates well with: 1) the actual difference in coiling indices at birth, 2) the intertwin birth weight difference and 3) the intertwin Doppler flow characteristics in the fetal cerebral and venous circulation.</p>","PeriodicalId":79506,"journal":{"name":"Journal of maternal-fetal investigation : the official journal of French Society of Ultrasound in Medicine and Biology ... [et al.]","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Differences between Twin Umbilical Coiling Indices Correlate to Differences in Twin Weight and Doppler Indices.\",\"authors\":\"Degani, Lewinsky, Aharoni, Gonen, Ohel\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>> Objective: The aim of our study was to evaluate sonographic and Doppler detectable differences in umbilical coiling index and fetoplacental circulation of discordant twins. Study Design: Doppler blood flow studies in 13 pairs of concordant and 20 pairs of discordant twins were performed from umbilical artery, middle cerebral artery, inferior vena cava, and ductus venosus. Flow studies were compared and correlated with the antenatal sonographic coiling index and the actual umbilical cord length, number of vascular helices, and birth weight. All studies were performed within 72 h before delivery. Pulsatility index (PI) values were calculated for the arteries and preload index (PLI) values for the veins. The umbilical coiling index (CI) was calculated using sonographic longitudinal views of cord vessels from several segments antenatally and by dividing the total number of helices by cord length (cm) postnatally. Discordancy was defined as a more than 20% intrapair actual birth weight difference. For all these index values the intertwin differences (Delta values) were calculated by subtracting the values obtained in the larger twin with those of the smaller twin. Results: The mean +/- SD intertwin difference in umbilical coiling index was 27.4 +/- 10.5% in the antepartum period and 28.9 +/- 10.0% after birth. Regression analysis showed a significant linear trend (r = 0.77, P < 0.001) between intertwin birth weight difference (DeltaBW) and intertwin coiling index difference (DeltaCI). A good correlation was found between DeltaCI and DeltaPLI in the ductus venosus (r = 0.63, P < 0.05), DeltaPLI in the inferior vena cava (r = 0.51, P < 0.005), and DeltaPI in the middle cerebral artery (r = 0.44, P < 0.05). Conclusions: Intertwin difference in antepartum umbilical coiling index can be determined by ultrasound and correlates well with: 1) the actual difference in coiling indices at birth, 2) the intertwin birth weight difference and 3) the intertwin Doppler flow characteristics in the fetal cerebral and venous circulation.</p>\",\"PeriodicalId\":79506,\"journal\":{\"name\":\"Journal of maternal-fetal investigation : the official journal of French Society of Ultrasound in Medicine and Biology ... 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[et al.]","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的:探讨超声和多普勒超声在胎儿脐带盘绕指数和胎胎盘循环方面的差异。研究设计:对13对和谐双胞胎和20对不和谐双胞胎从脐动脉、大脑中动脉、下腔静脉和静脉导管进行多普勒血流研究。将血流研究与产前超声盘绕指数、实际脐带长度、血管螺旋数和出生体重进行比较和关联。所有研究均在分娩前72小时内进行。计算动脉搏动指数(PI)值和静脉预负荷指数(PLI)值。脐带卷绕指数(CI)是通过产前脐带血管的几个节段的超声纵向视图和出生后脐带长度(cm)除以螺旋总数来计算的。不协调被定义为配对内实际出生体重差异超过20%。对于所有这些指标值,通过减去较大双胞胎中获得的值与较小双胞胎的值来计算双胞胎间的差异(Delta值)。结果:双生儿脐带盘绕指数的平均+/- SD差值产前为27.4 +/- 10.5%,产后为28.9 +/- 10.0%。回归分析显示,双生儿出生体重差(DeltaBW)与双生儿卷曲指数差(DeltaCI)呈显著的线性趋势(r = 0.77, P < 0.001)。静脉导管DeltaCI与DeltaPLI (r = 0.63, P < 0.05)、下腔静脉DeltaPLI (r = 0.51, P < 0.005)、大脑中动脉DeltaPI (r = 0.44, P < 0.05)具有良好的相关性。结论:双生儿产前脐带盘绕指数差异可通过超声确定,并与:(1)出生时实际盘绕指数差异、(2)双生儿出生体重差异、(3)胎儿脑静脉循环多普勒血流特征有较好的相关性。
Differences between Twin Umbilical Coiling Indices Correlate to Differences in Twin Weight and Doppler Indices.
> Objective: The aim of our study was to evaluate sonographic and Doppler detectable differences in umbilical coiling index and fetoplacental circulation of discordant twins. Study Design: Doppler blood flow studies in 13 pairs of concordant and 20 pairs of discordant twins were performed from umbilical artery, middle cerebral artery, inferior vena cava, and ductus venosus. Flow studies were compared and correlated with the antenatal sonographic coiling index and the actual umbilical cord length, number of vascular helices, and birth weight. All studies were performed within 72 h before delivery. Pulsatility index (PI) values were calculated for the arteries and preload index (PLI) values for the veins. The umbilical coiling index (CI) was calculated using sonographic longitudinal views of cord vessels from several segments antenatally and by dividing the total number of helices by cord length (cm) postnatally. Discordancy was defined as a more than 20% intrapair actual birth weight difference. For all these index values the intertwin differences (Delta values) were calculated by subtracting the values obtained in the larger twin with those of the smaller twin. Results: The mean +/- SD intertwin difference in umbilical coiling index was 27.4 +/- 10.5% in the antepartum period and 28.9 +/- 10.0% after birth. Regression analysis showed a significant linear trend (r = 0.77, P < 0.001) between intertwin birth weight difference (DeltaBW) and intertwin coiling index difference (DeltaCI). A good correlation was found between DeltaCI and DeltaPLI in the ductus venosus (r = 0.63, P < 0.05), DeltaPLI in the inferior vena cava (r = 0.51, P < 0.005), and DeltaPI in the middle cerebral artery (r = 0.44, P < 0.05). Conclusions: Intertwin difference in antepartum umbilical coiling index can be determined by ultrasound and correlates well with: 1) the actual difference in coiling indices at birth, 2) the intertwin birth weight difference and 3) the intertwin Doppler flow characteristics in the fetal cerebral and venous circulation.