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CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(09): 529-534
DOI: 10.1055/s-0040-1712128
Original Article
Obstetrics/High Risk Pregnancy

Twin Pregnancies, Crown-rump Length and Birthweight Discordancy: The Influence of Chorionicity

Gestações gemelares, comprimento craniocaudal e discordância de peso ao nascimento: a influência da corionicidade
Joana Sousa Nunes 
1   Obstetrics & Gynecology Department, Senhora da Oliveira Hospital, Guimarães, Portugal
2   Obstetrics & Gynecology Department, Faculty of Medicine, Minho University, Braga, Portugal
,
Mário Sousa 
3   Laboratory of Cell Biology, Microscopy Department, Porto Hospital Centre, Institute of Biomedical Sciences Abel Salazar, Porto University, Porto, Portugal
,
Nuno Montenegro 
4   Obstetrics & Gynecology Department, São João Hospital & University Centre, Porto, Portugal
,
Alexandra Matias 
4   Obstetrics & Gynecology Department, São João Hospital & University Centre, Porto, Portugal
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Abstract

Objective The purpose of the present study was to analyze the influence of chorionicity in the biometric parameters crown-rump length (CRL), birthweight (BW), crown-rump length discordancy (CRLD) and birthweight discordancy (BWD), determine the correlation between these latter two in cases of intertwin discordancy, and to analyze the influence of chronicity in the presence of these discordancies with clinical relevance (> 10% and > 15%, respectively).

Methods The present study was a retrospective study based on the twin pregnancy database of the Centro Hospitalar S. João (2010–2015), including 486 fetuses among 66 monochorionic (MC) and 177 dichorionic gestations (DC). The inclusion criteria were multiple pregnancies with 2 fetuses and healthy twin gestations. The exclusion criteria were trichorionic gestations and pregnancies with inconclusive chorionicity, multiple pregnancy with ≥ 3 fetuses and pathological twin gestations.

Results No statistically significant difference was found in BW (p = 0.09) and in its discordancy (p = 0.06) nor in CRL (p = 0.48) and its discordancy (p = 0.74) between MCs and DCs. Crown-rump length discordancy and birthweight discordancy were correlated by the regression line “BWD = 0.8864 x CRLD + 0.0743,” with r2  = 0.1599. Crown-rump length discordancy > 10% was found in 7.58% of monochorionic and in 13.56% of dichorionic twins. Birthweight discordancy > 15% was detected in 16.67% of monochorionic and in 31.64% of dichorionic twins.

Conclusion No statistically significant influence of chorionicity was identified in both birthweight and birthweight discordancy, as in crown-rump length and crown-rump length discordancy. Birthweight discordancy was correlated to crown-rump length discordancy in 20% of cases.

Resumo

Objetivo O objetivo do presente estudo foi analisar a influência da corionicidade nos parâmetros biométricos comprimento craniocaudal, peso ao nascimento, discordância de comprimento craniocaudal e discordância de peso ao nascimento, determinar a correlação entre estes dois últimos caso haja discordância intergemelar e analisar a influência da corionicidade na presença destas discordâncias com relevância clínica (> 10% e > 15%, respectivamente).

Métodos O presente estudo foi um estudo retrospectivo baseado na base de dados de gestações gemelares do Centro Hospitalar S. João (2010–2015), incluindo 486 fetos de 66 gestações monocoriônicas e 177 dicoriônicas. Os critérios de inclusão foram gestações múltiplas de 2 fetos e gestações gemelares saudáveis. Os critérios de exclusão foram gestações tricoriônicas ou de corionicidade inconclusiva, gestações múltiplas com ≥ 3 fetos e gestações gemelares patológicas.

Resultados Não se encontrou diferença estatisticamente significativa no peso ao nascimento (p = 0,09) e sua discordância (p = 0,06) nem no comprimento craniocaudal (p = 0,48) e sua discordância (p = 0,74) entre gestações monocoriônicas e dicoriônicas. Considerando todas as gestações, as discordâncias de comprimento craniocaudal e peso ao nascimento foram correlacionadas pela reta de regressão “discordância de peso ao nascimento = 0.8864 x discordância de comprimento craniocaudal + 0.0743,” com r2 = 0,1599. A discordância de comprimento craniocaudal > 10% descobriu-se em 7.58% das gestações monocoriônicas e em 13.56% das dicoriônicas. A discordância de peso ao nascimento > 15% detectou-se em 16.67% das gestações monocoriônicas e em 31.64% das dicoriônicas.

Conclusão Não se identificou influência estatisticamente significativa no peso ao nascimento e sua discordância, bem como no comprimento craniocaudal e sua discordância. A discordância de peso ao nascimento correlacionou-se com a discordância de comprimento craniocaudal em 20% dos casos.

Keywords

fetal growth - growth discordancy - crown-rump length - birthweight - chorionicity - twins

Palavras-chave

crescimento fetal - discordância de crescimento - comprimento craniocaudal - peso ao nascimento - corionicidade - gêmeos

Contributors

All of the authors contributed with the project and data interpretation, the writing of the article, the critical review of the intellectual content, and with the final approval of the version to be published.




Publication History

Received: 09 June 2019

Accepted: 02 April 2020

Article published online:
19 June 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

 

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