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Related Experiment Videos

Is it normal for multiples to be smaller than singletons?

Isaac Blickstein1

  • 1Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel. blick@netvision.net.il

Best Practice & Research. Clinical Obstetrics & Gynaecology
|July 29, 2004
PubMed
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Effect of gender on growth-restricted fetuses born preterm.

Journal of perinatal medicine·2019

Fetal growth in multiple pregnancies can appear restricted due to adaptation, not always genuine growth restriction. Recognizing the shift from physiological adaptation to pathological growth restriction is key for accurate assessment.

Area of Science:

  • Perinatology
  • Maternal-Fetal Medicine
  • Neonatology

Background:

  • Multiple pregnancies often show higher total fetal mass compared to singletons.
  • Individual fetuses may exhibit growth patterns reflecting adaptation to uterine constraints.
  • Distinguishing adaptive growth from pathological restriction is crucial.

Purpose of the Study:

  • To explore fetal growth patterns in multiple pregnancies.
  • To differentiate between adaptive growth and genuine fetal growth restriction.
  • To identify markers for the transition from adaptation to pathology.

Main Methods:

  • Review of fetal growth parameters in multiple gestations.
  • Analysis of birth weight percentiles for individual fetuses.

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  • Comparative assessment of growth patterns in relation to gestational age.

    • Main Results:

    • Individual fetuses may show growth compatible with adaptation, not necessarily restriction.
    • Relative growth restriction (discordance) can be an adaptive mechanism.
    • Even with significant discordance, smaller twins can remain above the 10th percentile.

    Conclusions:

    • Fetal growth in multiples requires nuanced interpretation beyond total mass.
    • Adaptive growth restriction is a distinct phenomenon from pathological fetal growth restriction.
    • Early recognition of the transition to pathological growth is vital for management.