title: Relevance of routine Doppler sampling at the two umbilical arteries in the follow-up of dichorionic twin pregnancies with intrauterine growth-restricted fetuses.
abstract: OBJECTIVE
  The aim of this study is to assess if the presence of bilateral absent or reverse end-diastolic velocity (AREDV) indicates a poorer prognosis than unilateral AREDV in dichorionic-diamniotic twin pregnancies complicated by intrauterine growth restriction.
  
  
  METHODS
  A prospective observational study of 36 dichorionic-diamniotic twin pregnancies complicated by intrauterine growth restriction. One hundred and fifty seven ultrasound (US) examinations were performed. The pulsatility indexes (PI) of the two umbilical arteries (UA-perivesical site), the middle cerebral artery (MCA) and the ductus venosus (DV) were recorded. The fetal hemodynamic status was represented by the existence of a bilateral positive end-diastolic velocity (PEDV), a unilateral AREDV or a bilateral AREDV in the umbilical arteries.
  
  
  RESULTS
  Bilateral PEDV, unilateral AREDV and bilateral AREDV represented respectively 66.0%, 10.6% and 23.4% of the US examinations. Intervals between Doppler examinations and delivery were significantly longer (P<0.005) in the bilateral PEDV group (26.5 days±19.7) than in the unilateral AREDV group (11.8 days±11.7) and in the bilateral AREDV group (11.0 days±8.6). MCA-PI, DV-PI, IFI and early neonatal outcomes did not differ between the unilateral and bilateral AREDV groups.
  
  
  CONCLUSIONS
  The routine measurement of the Doppler indices of the two umbilical arteries seems to be no more relevant than unilateral measurement in fetuses of dichorionic-diamniotic twin pregnancies complicated by intrauterine growth restriction.
authors.affiliation: Department of obstetrics and gynecology, hôpital Antoine-Béclère, université Paris Sud, Assistance publique des Hôpitaux de Paris, 92140 Clamart, France. Electronic address: alexvivanti@gmail.com.
authors.forename: A J
authors.initials: AJ
authors.lastname: Vivanti
authors.affiliation: Obstetrics and gynecology unit, maternité Port-Royal, Paris Descartes University, AP-HP, 75014 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Lecarpentier
authors.affiliation: Department of obstetrics and gynecology, hôpital Antoine-Béclère, université Paris Sud, Assistance publique des Hôpitaux de Paris, 92140 Clamart, France.
authors.forename: A-G
authors.initials: AG
authors.lastname: Cordier
authors.affiliation: Obstetrics and gynecology unit, maternité Port-Royal, Paris Descartes University, AP-HP, 75014 Paris, France; PremUp foundation (fondation pour la prévention de la prématurité et la protection du nouveau-né prématuré), 75014 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Proulx
authors.affiliation: Obstetrics and gynecology unit, maternité Port-Royal, Paris Descartes University, AP-HP, 75014 Paris, France; PremUp foundation (fondation pour la prévention de la prématurité et la protection du nouveau-né prématuré), 75014 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Tsatsaris
authors.affiliation: Department of obstetrics and gynecology, hôpital Antoine-Béclère, université Paris Sud, Assistance publique des Hôpitaux de Paris, 92140 Clamart, France; PremUp foundation (fondation pour la prévention de la prématurité et la protection du nouveau-né prématuré), 75014 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Benachi
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D005317:Fetal Growth Retardation; D005500:Follow-Up Studies; D006801:Humans; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000502:physiology; D011247:Pregnancy; D059285:Pregnancy, Twin; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology; D018608:Ultrasonography, Doppler; D014469:Umbilical Arteries / Q000000981:diagnostic imaging* / Q000502:physiology
keywords: Dichorionic-diamniotic; Doppler ultrasound; Intrauterine growth restriction; Twin pregnancy; Umbilical artery