Increased latency of absent end-diastolic flow in the umbilical artery of monochorionic twin fetuses

Vanderheyden, T. M., Fichera, A., Pasquini, L., Tan, T. Y. T., Wee, L. Y., Frusca, T. and Fisk, N. M. (2005) Increased latency of absent end-diastolic flow in the umbilical artery of monochorionic twin fetuses. Ultrasound in Obstetrics and Gynecology, 26 1: 44-49. doi:10.1002/uog.1900

Author Vanderheyden, T. M.
Fichera, A.
Pasquini, L.
Tan, T. Y. T.
Wee, L. Y.
Frusca, T.
Fisk, N. M.
Title Increased latency of absent end-diastolic flow in the umbilical artery of monochorionic twin fetuses
Journal name Ultrasound in Obstetrics and Gynecology   Check publisher's open access policy
ISSN 0960-7692
Publication date 2005-07-01
Sub-type Article (original research)
DOI 10.1002/uog.1900
Open Access Status
Volume 26
Issue 1
Start page 44
End page 49
Total pages 6
Place of publication Carnforth, U.K.
Publisher Parthenon
Language eng
Subject 111402 Obstetrics and Gynaecology
1114 Paediatrics and Reproductive Medicine
Formatted abstract
Objective: To determine if absent end-diastolic flow (AEDF) in the umbilical artery (UA) has a longer latency in monochorionic (MC) twin fetuses compared to singleton or dichorionic twin (DC) fetuses.
Methods: One hundred and eight pregnancies with a fetus with AEDF were reviewed: 47 MC and 17 DC twin pregnancies and 44 singletons. Because twin-twin transfusion syndrome (TTTS) is a potential confounder when determining latency, subgroup analysis was also performed on the 21 MC affected pregnancies without TTTS. Latency of AEDF (in days) was defined as the difference between the gestational age at diagnosis of AEDF and gestational age at delivery or intrauterine death.
Results: Latency was similar in MC twins (median, 39 days) and DC twins (30 days) but longer compared to singletons (11 days; P = 0.0001). After excluding pregnancies with TTTS, latency in non-TTTS MC twins (54 days) was longer than in both singletons and DC twins. This was due to an earlier gestational age at AEDF in non-TTTS MC twins of 20 weeks compared to 27 weeks in both singleton and DC twins because median gestational age at delivery was similar in MC twins, DC twins and singletons.
Conclusions: The latency period of UA AEDF is longer in MC twins than in singletons. Our data suggest that in MC twin fetuses without TTTS, AEDF begins earlier and lasts about twice as long as in DC twin fetuses, which is consistent with placental insufficiency not being the sole factor mediating abnormal UA waveforms in MC placentation. This observation is important in counseling and managing twin pregnancies discordant for AEDF.
Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.
Keyword Absent end-diastolic flow
Monochorionic twins
Umbilical artery Doppler
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
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