Utility of Doppler velocimetry in correlating with outcomes in severe discordant twins.
Twin birth weight discordance is associated with poor perinatal outcome. Three cases of severe discordant twins were serially assessed by ultrasound biometry and the Doppler ultrasonography of both the middle cerebral artery (MCA) and umbilical artery (UA) to measure pulsatility index (PI), resistance index (RI), and the systolic and diastolic ratio (S/D ratio). The birth weight discrepancies in three cases are 38%, 69% and 68%, respectively. Doppler velocimetry revealed a discrepancy in the S/D ratio of MCA and UA more than 15%. Absent end-diastolic flow, or the brain sparing effect, was noted in three small twins. Cerebral-umbilical S/D ratio (CUR) (MCA/UA) of the twins was above 1 in large ones and below 1 in small ones. The small twin in case 3 expired after delivery. In conclusion, if the CUR of the S/D ratio of the fetus is below 1, the prognosis might be poor and fetal weight discordancy might be progressively larger.
Ding
Dah-Ching
DC
Graduate Institute of Medical Science, School of Medicine, Tzu Chi University, Taiwan, R.O.C. dah1003@yahoo.com.tw
Hsu
Senzan
S
Chu
Ta-Wei
TW
Lai
Hung-Cheng
HC
Chen
Wei-Hua
WH
D001724:Birth Weight; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D017078:Laser-Doppler Flowmetry; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000502:physiology*; D011247:Pregnancy; D014427:Twins; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000502:physiology*; D014655:Vascular Resistance / Q000502:physiology*