+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Placental Histopathology Differences and Neonatal Outcome in Dichorionic-Diamniotic as Compared to Monochorionic-Diamniotic Twin Pregnancies

Placental Histopathology Differences and Neonatal Outcome in Dichorionic-Diamniotic as Compared to Monochorionic-Diamniotic Twin Pregnancies

Reproductive Sciences 25(7): 1067-1072

We aimed to compare the differences in placental histopathology lesions and pregnancy outcome in dichorionic-diamniotic (DCDA) versus uncomplicated monochorionic-diamniotic (MCDA) twin gestations. Maternal characteristics, neonatal outcome, and placental histopathology reports of all twin deliveries between 24 and 41 weeks were reviewed. Excluded were pregnancies complicated by twin-to-twin transfusion syndrome, twin anemia-polycythemia sequence, selective intrauterine growth restriction, placenta previa, intrauterine fetal death, and malformation. Placental lesions were classified to maternal/fetal vascular malperfusion lesions. Umbilical cord abnormalities included hypo-/hypercoiling and abnormal insertion. Composite adverse neonatal outcome was defined as 1 or more early complications. Small for gestational age (SGA) was defined as birth weight ≤10th percentile. The DCDA group (n = 362) was characterized by higher rates of assisted reproductive techniques ( P < .001) and nulliparity ( P = .03) as compared to the MCDA group (n = 65). Gestational age at delivery was similar between groups. Placental maternal vascular malperfusion lesions were more common in placentas from DCDA group (38.2% vs 23.1%; P = .016), while fetal vascular malperfusion lesions and abnormal cord insertion were more common in placentas from MCDA group ( P = .027; P< .001). The SGA and composite adverse neonatal outcome were more common in the MCDA group ( P = .031 and P = .038, respectively). By multivariate regression analysis, composite adverse neonatal outcome was found to be independently associated with the MCDA group, adjusted odds ratio (aOR) = 1.2, 95% confidence interval (CI) = 1.04 to 1.89, P = .041, and with placental fetal malperfusion lesions aOR = 1.3, 95% CI = 1.1 to 2.09, P = .038. Placental pathology differs between MCDA and DCDA twin pregnancies. Adverse neonatal outcome in uncomplicated MCDA twins, as compared to DCDA twins, could be related to increased placental fetal malperfusion lesions and abnormal cord insertion.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 060097855

Download citation: RISBibTeXText

PMID: 28969512

DOI: 10.1177/1933719117732163

Related references

Evaluation of placental vascularization indices in monochorionic diamniotic and dichorionic diamniotic twin pregnancies. European Journal of Obstetrics, Gynecology, and Reproductive Biology 228: 225-231, 2018

WS13-04Doppler velocimetry determined brain sparing effect: correlations with neonatal outcome in diamniotic monochorionic and diamniotic dichorionic twins. Ultrasound in Obstetrics & Gynecology 16(Suppl. S1): 24-24, 2000

Does mode of delivery alters the perinatal outcome in uncomplicated monochorionic diamniotic twin gestation (MCDA) in comparison to dichorionic diamniotic twin gestation (DCDA): 5 year data. Archives of Disease in Childhood - Fetal and Neonatal Edition 96(Suppl. 1): Fa64-Fa64, 2011

Outcome of fetoscopic laser ablation for twin-to-twin transfusion syndrome in dichorionic-triamniotic triplets compared with monochorionic-diamniotic twins. Ultrasound in Obstetrics and Gynecology 44(5): 545-549, 2015

Chromosomal aberrations and CNVs in twin fetuses with cardiovascular anomalies: Comparison between monochorionic diamniotic and dichorionic diamniotic twins. Prenatal Diagnosis 38(5): 318-327, 2018

Placental characteristics of monochorionic diamniotic twin pregnancies in relation to perinatal outcome. Placenta 29(11): 976-981, 2008

Monochorionic diamniotic twin pregnancies pregnancy outcome, risk stratification and lessons learnt from placental examination. Verhandelingen - Koninklijke Academie Voor Geneeskunde van Belgie 72(1-2): 5-15, 2010

Effect of mode of delivery on neonatal outcome of monochorionic diamniotic twin pregnancies: a retrospective cohort study. Journal of Reproductive Medicine 58(1-2): 15-18, 2013

Parameters associated with outcome in third trimester monochorionic diamniotic twin pregnancies. Journal of Obstetrics and Gynaecology Canada 32(5): 429-434, 2010

Outcome of monochorionic diamniotic twin pregnancies followed at a single center. Prenatal Diagnosis 35(11): 1057-1064, 2016

Outcome of dichorionic diamniotic twin pregnancies with spontaneous PPROM before 24 weeks' gestation. Journal of Maternal-Fetal & Neonatal Medicine 1-5, 2016

Placental Up-Regulation of Leptin and ARMS2 is Associated with Growth Discordance in Monochorionic Diamniotic Twin Pregnancies. Twin Research and Human Genetics 20(2): 169-179, 2017

Outcome of discordant growth in monochorionic diamniotic twin pregnancies in the 1st trimester, at 16, 20 and 26 weeks. 2007

First-trimester sonographic prediction of obstetric and neonatal outcomes in monochorionic diamniotic twin pregnancies. Journal of Ultrasound in Medicine 33(1): 135-140, 2014

A comparison of maternal and perinatal outcome between in vitro fertilization and spontaneous dichorionic-diamniotic twin pregnancies. Journal of Maternal-Fetal and Neonatal Medicine 30(24): 2974-2977, 2016