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Significance of biparietal diameter differences between twins
Insights
Significant differences in twin biparietal diameter (BPD) and birthweight indicate potential fetal compromise. Large BPD discrepancies in twins may signal one twin
Area of Science:
- Perinatology
- Maternal-Fetal Medicine
- Neonatology
Background:
- Twin gestations carry increased risks for adverse delivery and neonatal outcomes.
- Dissimilar fetal growth, particularly when severe, is a critical indicator of potential complications.
- Monitoring fetal growth parameters like biparietal diameter (BPD) and birthweight is essential in twin pregnancies.
Purpose of the Study:
- To investigate the correlation between significant differences in fetal growth parameters and adverse outcomes in twin pregnancies.
- To establish reference ranges for biparietal diameter (BPD) and birthweight discrepancies in twins with normal versus poor outcomes.
Main Methods:
- Retrospective analysis of sonographic data from 74 twin sets.
- Comparison of biparietal diameter (BPD) and birthweight differences between twins with normal and poor outcomes in the final scan before delivery.
- Statistical analysis to determine the significance of observed differences (P < 0.01).
Main Results:
- Twins with normal outcomes showed a mean BPD difference of 1.32 mm and a birthweight difference of 250.3 g.
- Twins with poor outcomes (intrauterine fetal demise or severe intrauterine growth retardation) exhibited significantly larger mean differences: 6.86 mm for BPD and 604.3 g for birthweight.
- Both BPD and birthweight differences were statistically significant (P < 0.01) between the two groups.
Conclusions:
- Large discrepancies in biparietal diameter (BPD) between twins are a potential indicator of compromised fetal well-being.
- Significant differences in BPD and birthweight can help identify twin gestations at higher risk for adverse outcomes.
- Early identification of growth discordance in twins through sonography is crucial for timely intervention and improved neonatal care.
Abstract:
Twins of dissimilar size have increased risks both at delivery and in the neonatal period. When dissimilar growth is severe, it should be reflected in birthweight and biparietal diameter (BPD) growth. Sonograms were done on 74 of 106 sets of twins delivered from July 1, 1973, to June 30, 1977. Excluding prematurity and birth trauma, the difference in BPD between twins with normal outcomes in the last scan prior to delivery was 1.32 +/- 0.20 mm (mean +/- SE) and the difference in birthweight was 250.3 +/- 31.4 g (mean +/- SE). In 7 sets of twins with poor outcomes (intrauterine fetal demise or severe intrauterine growth retardation) without central nervous system anomalies the difference in BPD between twins in the last scan, while both fetuses were alive, was 6.86 +/- 1.06 mm (mean +/- SE) and the difference in birthweight was 604.3 +/- 217.2 g (mean +/- SE). Both the BPDs and birthweights are significantly different at the P less than 0.01 level. Large differences in BPD between twins may possibly indicate compromise of one twin.