Is computerized cardiotocography useful in monochorionic twins with selective intrauterine growth restriction?

Details

Serval ID
serval:BIB_3AC1C427D62C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Is computerized cardiotocography useful in monochorionic twins with selective intrauterine growth restriction?
Journal
The journal of maternal-fetal & neonatal medicine
Author(s)
Bertrang Warncke A., Zbären S., Bolla D., Baumann M., Mosimann B., Surbek D., Baud D., Raio L.
ISSN
1476-4954 (Electronic)
ISSN-L
1476-4954
Publication state
In Press
Peer-reviewed
Oui
Pages
1-6
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Objective: To assess the value of using computerized cardiotocography (cCTG) short-term variation (STV) for intrapartum monitoring in monochorionic twins (MC) complicated by selective intrauterine growth restriction (sIUGR).Material and methods: All available cCTGs retrieved from computerized medical records of MC with sIUGR were retrospectively studied regarding the behavior of the STV. sIUGR was defined as intertwin estimated fetal weight (EFW) discordance of ≥20% with the abdominal circumference (AC) below the fifth percentile and/or the EFW of the smaller twin below the 10th percentile. The sIUGR classification system proposed by Gratacos et al. was used using types I-III on the basis of umbilical artery Doppler characteristics of the IUGR twin. The admission (entry) STV and final pre-delivery (last) STV values were analyzed. Cases with intrauterine demise, with structural or chromosomal abnormalities, with twin anemia polycythemia sequence (TAPS) and/or twin-to-twin transfusion syndrome (TTTS) were excluded.Results: During the study period, 64 consecutive cases were managed within our department. Thirty-two cases fulfilled the inclusion criteria for analysis. Mean gestational age at assessment and at delivery was 28.4 ± 2.7 and 31.5 ± 2.2 weeks, respectively. The entry STV and last STV before delivery were not statistically different (mean IUGR STV entry: 9.3 ± 3.4 ms versus last 8 ± 2.2 ms; p = .051; mean co-twin STV entry: 9.1 ± 2.8 ms versus last 9.2 ± 3 ms; p = .87). Neither was the sIUGR-type adjusted STV.Conclusions: In MC pregnancies complicated by sIUGR, the cCTG STV does not distinguish between fetuses, nor does it show differences in cases of fetal deterioration monitored by conventional CTG.
Keywords
Computerized cardiotocography, Doppler ultrasound, monochorionic twins, selective IUGR, short-term variability
Pubmed
Web of science
Create date
17/01/2020 16:30
Last modification date
17/07/2020 5:21
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