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Differences in fetal growth patterns between twins and singletons.

Liran Hiersch1, Rania Okby2, Howie Freeman2

  • 1Sackler Faculty of Medicine, Lis Maternity Hospital affiliated to Tel Aviv University, Tel Aviv, Israel.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|December 4, 2018
PubMed
Summary
This summary is machine-generated.

Twin fetuses show slower growth starting around 26 weeks, with abdominal circumference being most affected. This suggests a relative growth restriction in twin pregnancies compared to singletons.

Keywords:
Fetalgrowthpatternsingletonslowtwin

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Area of Science:

  • Perinatal Medicine
  • Fetal Development
  • Maternal-Fetal Medicine

Background:

  • Twin pregnancies often exhibit delayed fetal growth in the third trimester compared to singleton pregnancies.
  • The underlying mechanisms and classification of this growth pattern remain unclear, necessitating further investigation into fetal biometric indices.

Purpose of the Study:

  • To compare the fetal growth patterns of twin fetuses with those of singleton fetuses.
  • To analyze individual fetal biometric indices to understand differences in twin growth.

Main Methods:

  • Retrospective analysis of sonographic fetal weight estimations in uncomplicated twin pregnancies (16-38 weeks gestation).
  • Development of twin-specific regression models for biparietal diameter, head circumference, abdominal circumference, femur length, and fetal weight.
  • Comparison of twin growth curves with established singleton-based curves.

Main Results:

  • Twin fetuses showed lower estimated weights than singletons from 26 weeks gestation, with differences increasing to ~10% at term.
  • Slower growth in all biometric indices was observed in twins, most notably in abdominal circumference (contributing 51.7% to lower weight).
  • Higher head circumference/abdominal circumference ratio in twins from 22 weeks and a reduced diagnosis of small for gestational age using twin-specific curves.

Conclusions:

  • Twin fetuses experience growth deceleration around 26 weeks gestation and exhibit more asymmetric growth compared to singletons.
  • The findings suggest that slower twin growth may represent a state of relative growth restriction.
  • Development of twin-specific growth charts is crucial for accurate fetal assessment in twin pregnancies.