The purpose of this study is to evaluate the predictive value of CPR discordance at 16-20 weeks in MCDA twin pregnancies in predicting monochorionic-specific complications such as TTTS, TAPS, sFGR and IUFD of one or both fetuses
Aged 18 years or more and able to consent.
Monochorionic Diamniotic twin pregnancy.
Discordant inter-twin cerebroplacental ratio at 16-20 weeks of gestation.
Fetal structural malformations or chromosomal abnormalities in any of the twins as detected by anomaly scan antenatally or neonatal examination postnatally (chromosomal abnormalities and some congenital malformations can interfere with normal fetal growth).
Identified infectious etiologies detected during immediate postnatal examination or during pregnancy (fetal infections can cause FGR ,usually symmetric type particularly if they occur in early gestation).
Referral after development of Twin to twin transfusion syndrome, twin anemia polycythemia sequence or selective fetal growth restriction.
Single fetal demise at the time enrollment in the study.
Monochorionic diamniotic twin pregnancies with discordant cerebroplacental ratio at 16-20 weeks of gestation presenting to Ain Shams University Maternity Hospital for antenatal care.
Cohort
Prospective
Ultrasound
DeviceMeasuring cerebroplacental ratio discordance in monochorionic twins at 16-20 Weeks of gestation
Development of monochorionic specific complications
Monochorionic specific complications include twin to twin transfusion syndrome, twin anemia polycythemia sequence and selective fetal growth restriction
Occurrence of intrauterine fetal death or perinatal mortality of one or both fetuses
Gestational age upon occurrence of IUFD with clarifying if complications occur in the surviving twin in case of single fetal demise. Time and reason of perinatal mortality for any of the fetuses Wil be recorded.
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