Sonographic evaluation of umbilical cord thickness in monochorionic diamniotic twin pregnancies

Sonographic evaluation of umbilical cord thickness in monochorionic diamniotic twin pregnancies

Objective To develop a nomogram of the thickness of the umbilical cord (UC) and its components in monochorionic diamniotic (MCDA) twin pregnancies. Methods This prospective longitudinal study involved 47 MCDA twin pregnancies (94 fetuses) between 18 and 33 weeks of gestation. Ultrasound assessments...

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Bibliographic Details
Published in:Prenatal diagnosis Vol. 42; no. 5; pp. 636 - 642
Main Authors: Nunes, Clarissa Moraes, Biancolin, Sckarlet Ernandes, Miyadahira, Mariana Yumi, Peres, Stela Verzinhasse, Carvalho, Mario Henrique Burlacchini, Francisco, Rossana Pulcineli Vieira, Brizot, Maria de Lourdes
Format: Journal Article
Language:English
Published: England Wiley Subscription Services, Inc 01-05-2022
Subjects:
Correlation analysis
Female
Fetal Growth Retardation - diagnostic imaging
Fetal Weight
Fetuses
Gestational Age
Humans
Longitudinal Studies
Nomograms
Pregnancy
Pregnancy, Twin
Prospective Studies
Thickness
Twins
Twins, Dizygotic
Twins, Monozygotic
Ultrasonography, Prenatal
Umbilical Arteries - diagnostic imaging
Umbilical cord
Umbilical Cord - diagnostic imaging
Umbilical vein
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Summary:Objective To develop a nomogram of the thickness of the umbilical cord (UC) and its components in monochorionic diamniotic (MCDA) twin pregnancies. Methods This prospective longitudinal study involved 47 MCDA twin pregnancies (94 fetuses) between 18 and 33 weeks of gestation. Ultrasound assessments of UC cross‐sections and measurements of the umbilical cord area (UCA), the umbilical vein area (UVA), the umbilical artery area (UAA), and the Wharton jelly area (WJA) were made. The UC measurements were correlated with gestational ages. Reference values for the gestational ages of MCDA pregnancies were determined and compared with those of dichorionic twins and singletons. The cases which developed selective intrauterine growth restriction were contrasted with normal cases. Results A positive correlation was found between all UC components and gestational age and fetal weight. The UCA of MCDA fetuses was significantly larger than that of DC fetuses (p < 0.001) at the expense of a larger WJA (p < 0.001) and similar to that of singleton pregnancies. The MCDA fetuses with an estimated fetal weight below the 10th percentile had a smaller UCA than fetuses with a normal estimated weight (p < 0.001). Conclusion The MCDA twins exhibited a thicker UC than that of dichorionic twins. Key points What's already known about the topic? The umbilical cord can have its characteristics evaluated prenatally by ultrasound. Dichorionic fetuses have a thicker umbilical cord than single fetuses. What does this study add? Monochorionic fetuses have an umbilical cord thicker than that of dichorionic fetuses and of similar thickness as that of single fetuses. A thicker umbilical cord is due to an enlarged Whartonjelly area. The differences in cord thickness are possibly a consequence of placental shunts and amniotic fluid balance. Monochorionic growth‐restricted fetuses have thinner umbilical cords.
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ISSN:0197-3851
1097-0223
DOI:10.1002/pd.6141