Cerebroplacental blood flow redistribution in monochorionic‐diamniotic twin pregnancies with selective fetal growth restriction / 中华超声影像学杂志

ABSTRACT

Objective To analyze the cerebroplacental blood flow distribution characteristics in monochorionic‐diamniotic ( MCDA ) twin pregnancies with selective fetal grow th restriction ( sFGR ) ,and investigate the relationship between co‐twin cerebroplacental blood flow discordances and co‐twin birth weight discordances ( BWdisc ) . Methods The cerebroplacental blood flow distribution characteristics and their discordances were analyzed retrospectively in 52 MCDA twin pregnancies with normal grow th ( control group) and 52 with sFGR ( case group) ,including the umbilical artery pulsatility index ( U A‐PI) ,middle cerebral artery peak systolic velocity ( MCA‐PSV ) ,middle cerebral artery pulsatility index ( MCA‐PI ) , cerebroplacental ratio ( CPR ) ,and their discordances ( U A‐PIdisc ,MCA‐PSVdisc ,MCA‐PIdisc and CPRdisc ) . Results Compared to the control group ,UA‐PIdisc ,MCA‐PIdisc and CPRdisc increased significantly ( all P ＜0 .01) . U A‐PIdisc ,MCA‐PIdisc and CPRdisc were related positively to BW disc as show n by correlation analyses ( r＝0 .488 ,0 .414 ,0 .592 ;all P ＜ 0 .001) ,and they had moderate predictive accuracy for sFGR with area under the curves of 0 .743 ,0 .662 and 0 .778 , with sensitivity of 48 .08% ,67 .31% and 71 .15% , and specificity of 92 .31% ,59 .62% and 78 .85% ( all P ＜ 0 .01 ) . M ultivariate Logistic regression analyses showed that only CPRdisc were independently associated with sFGR ( P ＜ 0 .05 ) . Conclusions More cerebroplacental blood flow discordances are observed in MCDA twin pregnancies with sFGR . Co‐twin cerebroplacental blood flow discordance is related to BW disc .