Cerebral injury in monochorionic twins with selective intrauterine growth restriction: a systematic review.
Prenat Diagn
; 34(3): 205-13, 2014 Mar.
Article
en En
| MEDLINE
| ID: mdl-24338685
ABSTRACT
OBJECTIVE:
To estimate incidence and risk factors of severe cerebral injury in survivors from monochorionic pregnancies with selective intrauterine growth restriction (sIUGR) and/or birth weight discordance (BWD).METHODS:
Electronic databases were searched for studies describing perinatal and neurologic outcome in monochorionic twins with sIUGR and/or BWD. Exclusion criteria were twin-twin transfusion syndrome, twin anemia-polycythemia sequence, selective feticide or laser treatment.RESULTS:
Eleven articles were included in the systematic review. Analysis was hampered by different methodology and definitions of cerebral injury. The incidence of severe cerebral injury varied from 0% to 33% (average 8%, 52/661), and was higher in studies including single intrauterine demise [odds ratio (OR) 2.92; 95% confidence interval (CI) 0.89-9.56] and studies with a median gestational age at birth of ≤32 weeks (OR 1.56; 95% CI 1.06-2.27). The risk of severe cerebral injury was higher in pregnancies with abnormal umbilical artery Doppler (13.5% vs 2.5%; OR 7.69; 95% CI 2.56-25.00) and in larger twins (9% vs 5%; OR 1.93; 95% CI 0.95-3.92).CONCLUSIONS:
The incidence of severe cerebral injury in monochorionic twins with sIUGR and/or BWD is approximately 8% and is associated with abnormal umbilical artery Doppler, larger twins, intrauterine fetal demise and low gestational age at birth.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Gemelos Monocigóticos
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Peso al Nacer
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Lesiones Encefálicas
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Retardo del Crecimiento Fetal
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Prognostic_studies
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Risk_factors_studies
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Systematic_reviews
Límite:
Female
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Humans
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Newborn
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Pregnancy
Idioma:
En
Revista:
Prenat Diagn
Año:
2014
Tipo del documento:
Article
País de afiliación:
Países Bajos