Discordant growth in twins |
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Authors: | John C. P. Kingdom Ori Nevo Kellie E. Murphy |
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Affiliation: | 1. Department of Obstetrics and Gynecology (Maternal-Fetal Medicine Division), Mount Sinai Hospital, University of Toronto, Ontario, Canada;2. Department of Obstetrics and Gynecology (Maternal-Fetal Medicine Division), Mount Sinai Hospital, University of Toronto, Ontario, Canada Department of Clinical Epidemiology, Mount Sinai Hospital, University of Toronto, Ontario, Canada |
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Abstract: | Discordant growth in twins contributes significantly to rates of perinatal morbidity and mortality. These rates vary according to chorionicity, timing of onset and severity. We have reviewed English language literature in Medline since 1980. It is clear that diagnosis of discordant growth has improved due to the use of serial ultrasound examination. Following the detection of differences in fetal size, diagnosis is facilitated by umbilical artery and fetal Doppler studies. Management options vary according to chorionicity, timing of onset and umbilical-fetal Doppler studies. The mode of delivery in discordant twins remains controversial. We conclude that ultrasound surveillance of twin gestations, combining serial biometry and selective Doppler studies, is effective in the recognition of siginificant intrauterine growth restriction in co-twins. Differences in etiology and management underscore the imortance of establishing chorionicity routinely as soon as twin gestation is diagnosed. Copyright © 2005 John Wiley & Sons, Ltd. |
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Keywords: | twins discordant growth dichorionic monochorionic Doppler treatment screening diagnosis |
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