title: Management of Fetal Growth Arrest in One of Dichorionic Twins: Three Cases and a Literature Review.
abstract: Progressive fetal growth restriction (FGR) is often an indication for delivery. In dichorionic diamniotic (DD) twin pregnancy with growth restriction only affecting one fetus (selective fetal growth restriction: sFGR), the normal twin is also delivered prematurely. There is still not enough evidence about the optimal timing of delivery for DD twins with sFGR in relation to discordance and gestational age. We report three sets of DD twins with sFGR (almost complete growth arrest affecting one fetus for ≥2 weeks) before 30 weeks of gestation. The interval from growth arrest to delivery was 21-24 days and the discordance was 33.7-49.8%. A large-scale study showed no difference of overall mortality or the long-term outcome between immediate and delayed delivery for FGR, while many studies have identified a risk of developmental delay following delivery of the normal growth fetus before 32 weeks. Therefore, delivery of DD twins with sFGR should be delayed if the condition of the sFGR fetus permits in order to increase the gestational age of the normal growth fetus.
authors.affiliation: Department of Obstetrics and Gynecology, Shiga University of Medical Science, Shiga 520-2192, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Kaku
authors.affiliation: Department of Obstetrics and Gynecology, Shiga University of Medical Science, Shiga 520-2192, Japan.
authors.forename: Fuminori
authors.initials: F
authors.lastname: Kimura
authors.affiliation: Department of Obstetrics and Gynecology, Shiga University of Medical Science, Shiga 520-2192, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Murakami
references.citation: Eur J Obstet Gynecol Reprod Biol. 1991 Dec;42 Suppl:S73-8
references.pmid: 1809613
references.citation: BJOG. 2003 Jan;110(1):27-32
references.pmid: 12504932
references.citation: Am J Obstet Gynecol. 1994 Jan;170(1 Pt 1):48-53
references.pmid: 8296844
references.citation: Clin Perinatol. 2006 Dec;33(4):777-92; abstract viii
references.pmid: 17148004
references.citation: Acta Paediatr. 2010 May;99(5):684-9
references.pmid: 20491713
references.citation: Am J Obstet Gynecol. 2003 Apr;188(4):954-60
references.pmid: 12712093
references.citation: BJOG. 2008 Jan;115(1):58-67
references.pmid: 17999692
references.citation: BMJ. 1994 Jan 8;308(6921):111-2
references.pmid: 8298380
references.citation: J Obstet Gynaecol Res. 2011 Jan;37(1):24-31
references.pmid: 21083834
references.citation: Eur J Obstet Gynecol Reprod Biol. 1996 Aug;67(2):121-6
references.pmid: 8841799
references.citation: J Obstet Gynaecol. 2006 May;26(4):291-6
references.pmid: 16753674
references.citation: Am J Obstet Gynecol. 2011 Jan;204(1):34.e1-9
references.pmid: 21056403
references.citation: Lancet. 2004 Aug 7-13;364(9433):513-20
references.pmid: 15302194
references.citation: Obstet Gynecol Clin North Am. 2005 Mar;32(1):39-54, viii
references.pmid: 15644288
references.citation: Obstet Gynecol. 2002 Sep;100(3):474-80
references.pmid: 12220766