Routine Doppler ultrasound in twin pregnancy.

Area of Science:

• Perinatology
• Fetal Medicine
• Medical Imaging

Background:

• Doppler ultrasound is vital for monitoring high-risk twin pregnancies.
• Lack of recent multicenter trials hinders consensus on routine doppler use in uncomplicated twins.
• Existing guidelines offer limited specific recommendations for doppler surveillance in twin gestations.

Purpose of the Study:

• To review the role of doppler ultrasound in uncomplicated twin pregnancy surveillance.
• To compare growth trajectories and doppler abnormality progression in twins versus singletons.
• To provide recommendations for doppler surveillance strategies in uncomplicated twins.

Main Methods:

• Review of international clinical guidelines.
• Analysis of differences in growth and doppler progression between twins and singletons.
• Synthesis of recent studies to inform recommendations.

Main Results:

• There is a lack of international consensus on routine doppler ultrasound (umbilical artery, middle cerebral artery, cerebroplacental ratio, uterine artery, ductus venosus) in uncomplicated twins.
• Twins exhibit distinct growth trajectories and doppler abnormality progression compared to singletons.
• Current evidence does not support routine use of all doppler parameters in all uncomplicated twin pregnancies.

Conclusions:

• Further research is needed to establish evidence-based guidelines for doppler surveillance in uncomplicated twins.
• Selective or tailored doppler monitoring may be more appropriate than routine universal application.
• Appropriate use of doppler ultrasound remains essential for managing high-risk twin pregnancies.