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First trimester ultrasonography of multiple gestations: a review
1Department of Obstetrics and Gynecology & Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Obstetrical & Gynecological Survey
|November 13, 1998
Summary
First trimester ultrasonography, particularly transvaginal sonography, offers early and precise insights into multiple gestations. This enhances diagnosis, management, and guidance for procedures like chorionic villus sampling.
Area of Science:
- Obstetrics and Gynecology
- Medical Imaging
- Reproductive Medicine
Background:
- Multiple gestations present unique diagnostic and management challenges.
- Advancements in ultrasonography have improved early pregnancy assessment.
Purpose of the Study:
- To review current literature on first-trimester ultrasonography in multiple gestations.
- To highlight the diagnostic and management benefits of early ultrasound in these pregnancies.
Main Methods:
- Comprehensive MEDLINE search of English-language manuscripts from 1966 to May 1998.
- Inclusion of additional sources through cross-referencing.
Main Results:
- First-trimester ultrasonography enables early detection of fetal viability, chorionicity, and pregnancy outcomes.
- It aids in identifying structural abnormalities, twin reverse arterial perfusion sequence, and aneuploidy markers.
- Transvaginal sonography provides enhanced detail for assessing fetal growth discordancy and guiding procedures like amniocentesis and selective fetal reduction.
Conclusions:
- High-resolution, first-trimester transvaginal ultrasonography is crucial for stratifying management of multiple gestations.
- Obstetricians should be aware of its advantages due to the rising incidence of multiple pregnancies.