Crown−rump length discordance in the first trimester: a predictor of adverse outcome in twin pregnancies?

Crown−rump length discordance in the first trimester: a predictor of adverse outcome in twin pregnancies?

ABSTRACT Objectives To evaluate the usefulness of first‐trimester crown−rump length (CRL) discordance in predicting adverse outcome in twin pregnancies. Methods This retrospective study included a large cohort retrieved from local ultrasound databases at 14 obstetric departments in Denmark, comprisi...

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Bibliographic Details
Published in:Ultrasound in obstetrics & gynecology Vol. 43; no. 3; pp. 277 - 283
Main Authors: Johansen, M. L., Oldenburg, A., Rosthøj, S., Maxild, J. Cohn, Rode, L., Tabor, A.
Format: Journal Article
Language:English
Published: Chichester, UK John Wiley & Sons, Ltd 01-03-2014
Wiley Subscription Services, Inc
Subjects:
Birth Weight
CRL discordance
Crown-Rump Length
Denmark
Female
Fetal Death
Fetal Growth Retardation - diagnostic imaging
fetal loss
Humans
Infant, Newborn
outcome of pregnancy
Predictive Value of Tests
Pregnancy
Pregnancy Outcome
Pregnancy Trimester, First
Pregnancy, Twin
Premature birth
Premature Birth - diagnostic imaging
preterm delivery
Retrospective Studies
Risk Assessment
ROC Curve
twin pregnancy
Twins
Twins, Dizygotic
Twins, Monozygotic
Ultrasonic imaging
Ultrasonography, Prenatal
outcome of pregnancy
fetal loss
CRL discordance
preterm delivery
twin pregnancy
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Summary:ABSTRACT Objectives To evaluate the usefulness of first‐trimester crown−rump length (CRL) discordance in predicting adverse outcome in twin pregnancies. Methods This retrospective study included a large cohort retrieved from local ultrasound databases at 14 obstetric departments in Denmark, comprising all twin pregnancies with two live fetuses scanned between 11 and 14 weeks' gestation during the period 1 January 2004 to 31 December 2006. The association between CRL discordance ≥ 10 % and adverse outcome was evaluated. Results Among 1993 twin pregnancies, 1733 were dichorionic (156 (9%) discordant; 1577 (91%) concordant) and 260 were monochorionic (32 (12%) discordant; 228 (88%) concordant). In dichorionic twin pregnancies we found an association between CRL discordance ≥ 10% and preterm delivery before 34 weeks' gestation (P = 0.007), birth weight discordance (P = 0.001) and mean birth weight (P = 0.033). In monochorionic twin pregnancies we found an association between CRL discordance ≥ 10% and birth weight discordance (P = 0.02) and mean birth weight (P = 0.03). To evaluate CRL discordance as a predictor of fetal loss and preterm delivery before 34 weeks' gestation, receiver−operating characteristics curves were created for each outcome. For CRL discordance ≥ 10% as a predictor of fetal loss and preterm delivery in dichorionic twin pregnancies, sensitivity was 0.17 (95% CI, 0.06−0.28) and 0.14 (95% CI, 0.10−0.18), respectively, and in monochorionic twin pregnancies it was 0.10 (95% CI, 0.03−0.22) and 0.16 (95% CI, 0.06−0.26), respectively. Conclusions CRL discordance in twin pregnancies is associated with, but is not a strong predictor of, adverse outcome. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd Linked Comment: Ultrasound Obstet Gynecol 2014; 43: 246–246
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ISSN:0960-7692
1469-0705
DOI:10.1002/uog.12534