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Erschienen in:
29.07.2020 | Original Article
First-Trimester Crown-Rump Length (CRL) and Nuchal Translucency (NT) Discordance in Monochorionic Twins: An Ominous Sign or a Benign Feature?
Erschienen in: The Journal of Obstetrics and Gynecology of India | Ausgabe 5/2020
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Background
This study aimed to evaluate the usefulness of the first-trimester crown-rump length (CRL) and nuchal translucency (NT) discordance in monochorionic diamniotic twins (MCDA) for the prediction of complications—twin–twin transfusion syndrome (TTTS), selective fetal growth restriction (sFGR) or intrauterine fetal demise (IUFD).
Methods
Intertwin discordance in the CRL and NT was calculated as a percentage of the larger CRL and NT, respectively. The performance of inter twin discordance (CRL ≥ 10% and NT≥ 20%) for predicting complications was analysed using standard statistical screening test methods.
Results
Fifty-eight MCDA twin pregnancies were studied. Out of them, 19 (32%) pregnancies resulted in one of the complications studied (4 TTTS, 10 sFGR, 5 IUFD). CRL and NT discordance showed an increased probability of developing complications positive likelihood ratio (LR+) {95% confidence interval}: 2.05 {0.46–9.23} and 1.88 {1.03–3.45}, respectively. NT discordance showed a sensitivity of 57%.
Conclusions
Although discordant first-trimester CRL and NT in monochorionic twins are poor screening tools for early prediction, if positive, they increase the risk of developing complications.