title: Placental pathology, birthweight discordance, and growth restriction in twin pregnancy: results of the ESPRiT Study.
abstract: OBJECTIVE
  We sought to evaluate the association between placental histological abnormalities and birthweight discordance and growth restriction in twin pregnancies.
  
  
  METHODS
  We performed a multicenter, prospective study of twin pregnancies. Placentas were examined for evidence of infarction, retroplacental hemorrhage, chorangioma, subchorial fibrin, or abnormal villus maturation. Association of placental lesions with chorionicity, birthweight discordance, and growth restriction were assessed.
  
  
  RESULTS
  In all, 668 twin pairs were studied, 21.1% monochorionic and 78.9% dichorionic. Histological abnormalities were more frequent in placentas of smaller twins of birthweight discordant pairs (P = .02) and in placentas of small for gestational age infants (P = .0001) when compared to controls. The association of placental abnormalities with both birthweight discordance and small for gestational age was significant for dichorionic twins (P = .01 and .0001, respectively). No such association was seen in monochorionic twins.
  
  
  CONCLUSIONS
  In a large, prospective, multicenter study, we observed a strong relationship between abnormalities of placental histology and birthweight discordance and growth restriction in dichorionic, but not monochorionic, twin pregnancies.
authors: Royal College of Surgeons in Ireland, Dublin, Ireland. ekent@rcsi.ie
authors: Etaoin M
authors: EM
authors: Kent
authors: Fionnuala M
authors: FM
authors: Breathnach
authors: John E
authors: JE
authors: Gillan
authors: Fionnuala M
authors: FM
authors: McAuliffe
authors: Michael P
authors: MP
authors: Geary
authors: Sean
authors: S
authors: Daly
authors: John R
authors: JR
authors: Higgins
authors: Alyson
authors: A
authors: Hunter
authors: John J
authors: JJ
authors: Morrison
authors: Gerard
authors: G
authors: Burke
authors: Shane
authors: S
authors: Higgins
authors: Stephen
authors: S
authors: Carroll
authors: Patrick
authors: P
authors: Dicker
authors: Fiona
authors: F
authors: Manning
authors: Elizabeth
authors: E
authors: Tully
authors: Fergal D
authors: FD
authors: Malone
mesh_terms: D001724:Birth Weight; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D010922:Placenta Diseases / Q000473:pathology; D011247:Pregnancy; D011446:Prospective Studies; D014429:Twins, Dizygotic; D014430:Twins, Monozygotic; D016216:Ultrasonography, Prenatal