title: Intrauterine growth restriction in monochorionic-diamniotic twins.
abstract: OBJECTIVE
  to evaluate neonatal morbidity and mortality in monochorionic-diamniotic (MCDA) twin pregnancies complicated by selective intrauterine growth restriction (sIUGR) and non-selective intrauterine growth resctriction (nsIUGR).
  
  
  METHODS
  neonatal morbidity parameters and mortality were analyzed in 34 twins with IUGR (< 10th percentile on twins' growth charts): 18 with sIUGR and 16 with nsIUGR. The sIUGR group was made up of 18 pregnancies in which growth was restricted in only one fetus (n = 18). The nsIUGR group was composed of 8 pregnancies in which both fetuses presented restricted growth (n = 16). Cases of twin-to-twin transfusion syndrome and fetal malformation were not included in the study.
  
  
  RESULTS
  the MCDA twin pregnancies with sIUGR had a higher rate of orotracheal intubation (p = 0.001) and mechanical ventilation (p = 0.0006), as well as longer than average fasting time (p = 0.014) compared to those in which the fetuses had nsIUGR. A higher incidence was also observed of types II and III umbilical artery Doppler velocimetry patterns in the sIUGR cases (p = 0.002). There was no significant difference between the two groups as to mortality during pregnancy and the neonatal period (p = 0.09).
  
  
  CONCLUSIONS
  in MCDA twin pregnancies, sIUGR presents more severe umbilical artery Doppler velocimetry abnormalities and worse morbidity than nsIUGR.
authors: Department of Obstetric, Hospital das Clínicas, University of São Paulo's Medical School, São Paulo, SP, Brazil.
authors: Rita de Cássia Alam
authors: Rde C
authors: Machado
authors: Department of Obstetric, Hospital das Clínicas, University of São Paulo's Medical School, São Paulo, SP, Brazil.
authors: Maria de Lourdes
authors: Mde L
authors: Brizot
authors: Department of Obstetric, Hospital das Clínicas, University of São Paulo's Medical School, São Paulo, SP, Brazil.
authors: Seizo
authors: S
authors: Miyadahira
authors: Department of Obstetric, Hospital das Clínicas, University of São Paulo's Medical School, São Paulo, SP, Brazil.
authors: Rossana Pulcineli Vieira
authors: RP
authors: Francisco
authors: Department of Pediatrics, Hospital das Clínicas, University of São Paulo's Medical School, São Paulo, SP, Brazil.
authors: Vera Lúcia Jornada
authors: VL
authors: Krebs
authors: Department of Obstetric, Hospital das Clínicas, University of São Paulo's Medical School, São Paulo, SP, Brazil.
authors: Marcelo
authors: M
authors: Zugaib
mesh_terms: D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005215:Fasting; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000401:mortality; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D017078:Laser-Doppler Flowmetry / Q000379:methods; D007902:Length of Stay; D008297:Male; D009017:Morbidity; D054238:Perinatal Mortality; D011247:Pregnancy; D059285:Pregnancy, Twin; D012121:Respiration, Artificial; D012189:Retrospective Studies; D014430:Twins, Monozygotic / Q000706:statistics & numerical data*; D014463:Ultrasonography; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology