title: Prognostic value of umbilical and cerebral Doppler in fetal growth restriction: comparison of dichorionic twins and singletons.
abstract: OBJECTIVE
  To compare the prognostic value of fetal Doppler in dichorionic twins and singletons by measuring the interval between diagnosis of an abnormal Doppler flow and birth in fetuses who are small for gestational age (SGA).
  
  
  METHODS
  Comparative retrospective study using a prospectively collected database.
  
  
  METHODS
  A level 3 maternity unit in France.
  
  
  METHODS
  Fetuses from singleton and dichorionic pregnancies who are SGA (vascular or unexplained), defined by an abdominal circumference (AC) measurement below the 10th percentile and confirmed by a birth weight below the 10th percentile.
  
  
  METHODS
  Fisher's exact and Chi-2 tests were used to compare frequencies, and the Mann-Whitney-Wilcoxon test was used to compare medians in non-Gaussian distributions.
  
  
  METHODS
  Both neonatal outcomes and intervals between the first Doppler abnormality and birth were compared in the groups of dichorionic twins and singletons.
  
  
  RESULTS
  Obstetric and neonatal outcome were similar in the 104 SGA dichorionic twins and 170 SGA singletons. Abnormalities of umbilical artery Doppler, regardless of type, appeared at the same frequency in both groups (52.9%) but were identified earlier in twins (25 versus 28 weeks, p = 0.02). Among fetuses with abnormal Doppler flow, the interval between the finding and birth was significantly longer in the twins than the singletons (44 vs 15 days, p<0.01).
  
  
  CONCLUSIONS
  The prognostic value of an abnormal Doppler finding for the course of a pregnancy may be different in dichorionic twins and singletons. The management of women carrying SGA twins and the information provided to them should take these results into account.
authors: Department of Obstetrics and Gynaecology, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris, 53 avenue de l'observatoire, 75014 Paris, France; Universitary Hospital Departement (DHU) Risks in pregnancy, Paris, France.
authors: Sarah
authors: S
authors: Vanlieferinghen
authors: Department of Obstetrics and Gynaecology, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris, 53 avenue de l'observatoire, 75014 Paris, France; PremUP Foundation for scientific cooperation in connection with pregnancy and prematurity, 53 avenue de l'observatoire, 75014 Paris, France; Universitary Hospital Departement (DHU) Risks in pregnancy, Paris, France.
authors: Olivia
authors: O
authors: Anselem
authors: Department of Obstetrics and Gynaecology, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris, 53 avenue de l'observatoire, 75014 Paris, France; PremUP Foundation for scientific cooperation in connection with pregnancy and prematurity, 53 avenue de l'observatoire, 75014 Paris, France; French Institute of Health and Medical Research (INSERM) Unit 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Research Center for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris, France; Universitary Hospital Departement (DHU) Risks in pregnancy, Paris, France.
authors: Camille
authors: C
authors: Le Ray
authors: Department of Obstetrics and Gynaecology, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris, 53 avenue de l'observatoire, 75014 Paris, France; Universitary Hospital Departement (DHU) Risks in pregnancy, Paris, France.
authors: Yao
authors: Y
authors: Shen
authors: Department of Obstetrics and Gynaecology, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris, 53 avenue de l'observatoire, 75014 Paris, France; PremUP Foundation for scientific cooperation in connection with pregnancy and prematurity, 53 avenue de l'observatoire, 75014 Paris, France; Universitary Hospital Departement (DHU) Risks in pregnancy, Paris, France.
authors: Louis
authors: L
authors: Marcellin
authors: Department of Obstetrics and Gynaecology, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris, 53 avenue de l'observatoire, 75014 Paris, France; PremUP Foundation for scientific cooperation in connection with pregnancy and prematurity, 53 avenue de l'observatoire, 75014 Paris, France; French Institute of Health and Medical Research (INSERM) Unit 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Research Center for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris, France; Universitary Hospital Departement (DHU) Risks in pregnancy, Paris, France.
authors: François
authors: F
authors: Goffinet
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D059285:Pregnancy, Twin; D011379:Prognosis; D012307:Risk Factors; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging* / Q000473:pathology