Role of Cerebroplacental Ratio Discordance at 16-20 Weeks in Predicting Monochorionic Twin Pregnancies' Specific Complications

Ain Shams Maternity Hospital55 enrolled

Overview

The purpose of this study is to evaluate the predictive value of CPR discordance at 16-20 weeks in MCDA twin pregnancies in predicting monochorionic-specific complications such as TTTS, TAPS, sFGR and IUFD of one or both fetuses

Monochorionic (MC) twin pregnancies are at a higher risk of perinatal morbidity and mortality because of the risk of developing unique complications. These include twin to twin transfusion syndrome (TTTS), selective fetal growth restriction (sFGR) , twin anemia polycythemia sequence (TAPS) and intrauterine fetal death (IUFD) of one or both fetuses. Therefore, early identification of these conditions is warranted to plan proper perinatal surveillance and management to improve outcome. Sparse studies have found that inter-twin differences in Doppler ultrasound may occur prior to meeting diagnostic criteria for TTTS, TAPS, sFGR or adverse perinatal outcomes. This study will try to reveal the potential clinical predictive value of inter-twin cerebroplacental ratio (CPR) discordance in the surveillance of MC twin pregnancies.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Monochorionic Twins Cerebroplacental Ratio

Interventions

UltrasoundDEVICE

Measuring cerebroplacental ratio discordance in monochorionic twins at 16-20 Weeks of gestation

Eligibility

Sex: FEMALE

Medical Language ↔ Plain English

Inclusion Criteria: * Aged 18 years or more and able to consent. * Monochorionic Diamniotic twin pregnancy. * Discordant inter-twin cerebroplacental ratio at 16-20 weeks of gestation. Exclusion Criteria: * Fetal structural malformations or chromosomal abnormalities in any of the twins as detected by anomaly scan antenatally or neonatal examination postnatally (chromosomal abnormalities and some congenital malformations can interfere with normal fetal growth). * Identified infectious etiologies detected during immediate postnatal examination or during pregnancy (fetal infections can cause FGR ,usually symmetric type particularly if they occur in early gestation). * Referral after development of Twin to twin transfusion syndrome, twin anemia polycythemia sequence or selective fetal growth restriction. * Single fetal demise at the time enrollment in the study. * Conjoint twins.

Locations (1)

Ain shams maternity hospital

Cairo, Egypt

RECRUITING

Outcomes

Primary Outcomes

Development of monochorionic specific complications

Monochorionic specific complications include twin to twin transfusion syndrome, twin anemia polycythemia sequence and selective fetal growth restriction

Time frame: From 16-20 weeks of gestation till delivery.

Secondary Outcomes

Occurrence of intrauterine fetal death or perinatal mortality of one or both fetuses

Gestational age upon occurrence of IUFD with clarifying if complications occur in the surviving twin in case of single fetal demise. Time and reason of perinatal mortality for any of the fetuses Wil be recorded.

Time frame: From 16-20 weeks of gestation till 7th day of life

Central Contacts

Muhammed Ali Hassan, Assistant lecturer

CONTACT

+201020256117 muhammedali20191@yahoo.com

Mohamed Sameh Elswaify, Lecturer

CONTACT

+201285003060

Data from ClinicalTrials.gov

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