title: Decreased Total Placental Mass Found in Twin-Twin Transfusion Syndrome Gestations with Selective Growth Restriction.
abstract: BACKGROUND
  We examined placental weight characteristics associated with donor selective intrauterine growth restriction (SIUGR) among patients with twin-twin transfusion syndrome (TTTS) who underwent laser surgery.
  
  
  METHODS
  Fresh placental specimens were studied. Pregnancies with higher-order multiples, fetal demise, or disrupted or nonsubmitted placental specimens were excluded. Placental characteristics prospectively collected included total placental weight, individual placental weight, and placental share. Data were compared between pregnancies with SIUGR (TTTS + SIUGR group) and those without SIUGR (TTTS-only group).
  
  
  RESULTS
  Of 369 consecutive patients who underwent laser surgery for TTTS, 155 (42%) met inclusion criteria: 91 with TTTS + SIUGR and 64 with TTTS-only. Compared to the TTTS-only group, patients in the TTTS + SIUGR group had a lower total placental weight (608 ± 163 vs. 687 ± 224 g, p = 0.012), with a lower donor individual placental weight (237 ± 91 vs. 291 ± 124 g, p = 0.002), but no apparent difference in the individual placental weight of recipient twins (371 ± 109 vs. 396 ± 133 g, p = 0.211). Donor placental share was smaller in those pregnancies affected by SIUGR (38.7 ± 9.6 vs. 42.3 ± 9.8%, p = 0.029).
  
  
  CONCLUSIONS
  TTTS patients with SIUGR had a lower total placental weight and a lower donor individual placental weight compared to those without SIUGR. These findings suggest that differences in donor individual placental weights for SIUGR gestations may not solely be related to differences in placental share.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, Calif., USA.
authors.forename: Kristi R
authors.initials: KR
authors.lastname: Van Winden
authors.forename: Rubén A
authors.initials: RA
authors.lastname: Quintero
authors.forename: Eftichia V
authors.initials: EV
authors.lastname: Kontopoulos
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Korst
authors.forename: Arlyn
authors.initials: A
authors.lastname: Llanes
authors.forename: Ramen H
authors.initials: RH
authors.lastname: Chmait
mesh_terms: D005260:Female; D005317:Fetal Growth Retardation / Q000473:pathology*; D005330:Fetofetal Transfusion / Q000473:pathology*; D006801:Humans; D017075:Laser Coagulation; D016015:Logistic Models; D016017:Odds Ratio; D009929:Organ Size; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy