Journal
BEST PRACTICE & RESEARCH CLINICAL OBSTETRICS & GYNAECOLOGY
Volume 28, Issue 2, Pages 295-303Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.bpobgyn.2013.12.003
Keywords
growth; discordance; monochorionic; dichorionic; twin; pregnancy
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Funding
- fetal medicine research programs of the University Hospitals Leuven: Fonds voor Wetenschappelijk Onderzoek Vlaanderen (FWO) [1.8.012.07.N.02]
- Instituut voor Wetenschap en Technologie [IWT/070715]
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Poor growth is a common problem in twin pregnancies, and management poses some unique challenges as the wellbeing of both twins have to be taken into account at all times. The decision to deliver the twins to prevent an intrauterine demise of the growth-restricted twin will, therefore, depends on the chances of intact postnatal survival of both twins. In monochorionic twins, management is complicated further by the fact that the wellbeing of one twin critically depends on that of the other twin because of the shared circulation. In the event of demise of the growth-restricted twin, the larger twin may also die or sustain brain damage because of an acute exsanguination into the feto-placental unit of its demised co-twin. In the pre-viable period, invasive fetal therapy may, therefore, be indicated to protect the appropriately growing twin. (C) 2013 Elsevier Ltd. All rights reserved.
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