What is discordant growth?

Twin growth discordance is a term used in obstetric imaging to describe a significant size or weight difference between the two fetuses of a twin pregnancy. To be classified as a growth discordance, some consider that the estimated fetal weight

fetal weight

Birth weight is the body weight of a baby at its birth. The average birth weight in babies of European descent is 3.5 kilograms (7.7 lb), with the normative range between 2.5 and 4.5 kilograms (5.5 and 9.9 lb).

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Birth weight - Wikipedia

(EFW) of the smaller twin should fall under the 10^th centile.

What is fetal growth discordance?

Birth weight discordance was defined as a difference of 20% or more of the weight of the heavier twin, associated with an intra-uterine growth restriction (10(th) percentile) of at least one twin. Ultrasound discordance was defined as a difference of estimated fetal weight>20%.

What is weight discordance?

Birth weight discordance =(larger twin weight−smaller twin weight) / larger twin weight×100.

What is normal discordance in twins?

Discordant growth is not a chance event and therefore several patterns can be discerned. About 75% of twins exhibit < 15% discordance (concordant), 20% are 15-25% (mildly) discordant, and about 5% are more than 25% (severely) discordant. Higher frequencies and increased severity are seen among triplets.

What causes twin growth discordance?

The causes of twin growth discordance are often unknown. The most important is considered to be monochorionicity, mainly because of unequal sharing, or of velamentous cord insertions in the IUGR twin [20]. Other possible causes are “intrauterine crowding” and the presence of malformations [21-23].

Selective Intrauterine Growth Restriction (sIUGR) or Twin-Twin Transfusion Syndrome (TTTS)? (9 of 9)

What happens when one twin is bigger than the other?

Twin to Twin Transfusion Syndrome (TTTS) is a prenatal condition in which twins share unequal amounts of the placenta's blood supply resulting in the two fetuses growing at different rates. 70% of identical twins share a placenta, and 15-20% of these pregnancies are affected by TTTS.

What happens if one twin is smaller than the other?

Depending on where they implant, one twin may get a smaller share of the placenta than the other, resulting in less blood flow and nutrition to one fetus, and more to the other. This is called unequal placental sharing. As a result, the twins may grow differently.

What are the ultrasound criteria for discordant growth in monochorionic twinning?

Conventionally, sFGR is a term applied to twin pregnancies in which one fetus has an EFW < 10th centile and the intertwin EFW discordance is > 25%61,62. The American College of Obstetricians and Gynecologists considers a difference of 15–25% in the EFW to constitute discordant fetal growth63.

What is the weight difference between twins?

Birth weight differences of more than 20% in twins is associated with poor outcomes for the mother and baby. Clinicians measure the estimated fetal weight differences by ultrasound before birth and compare it to differences in birth weight after the babies are born.

What causes fetus Papyraceus?

It results from failure to completely reabsorb the dead fetus. The cause is usually unknown, but is associated with twin-to-twin transfusion (TTTS), fetal genetic or chromosomal abnormalities and improper cord implantation such as velamentous cord insertion. There can be maternal and fetal complications.

What locked twins?

Locking or locked twins is a rare condition in which during birth, a fetus in a breech position becomes locked at the chin with his twin fetus who is in a vertex position. And, it occurs in about 1 in every 1000 twin births. The stillbirth rate of locked twins is estimated to be 50%.[1]

What is Dichorionic Diamniotic twin?

Definition. The term dichorionic refers to multiple gestations with two distinct placental disks (or two chorions), and the term diamniotic describes a pregnancy with two distinct amniotic cavities. A dichorionic diamniotic twin pregnancy is a twin pregnancy in which each fetus has its own placenta and amniotic sac.

What does Dye Dye twins mean?

This means they can appear nearly identical or completely different. They can be different sexes with different hair and eye colors or the same sex and look very similar. Fraternal twins are also called dizygotic twins, because they come from two different eggs.

What does AFI mean on an ultrasound?

Amniotic fluid index (AFI) is one of the major and deciding components of fetal biophysical profile and by itself it can predict pregnancy outcome.

What is a trap pregnancy?

Twin reversed arterial perfusion (TRAP sequence) is a rare condition of monochorionic twin pregnancies. It arises when the cardiac system of one twin does the work of supplying blood for both twins. The twin supplying the blood is known as the "pump twin" and develops normally in the womb.

How is EFW calculated in pregnancy?

Plug those measurements in the following formula to find the estimated fetal weight: log₁₀(Fetal weight) = 1.3596 - (0.00386 × AC × FL) + (0.0064 × HC) + (0.00061 × BPD × AC) + (0.0424 × AC) + (0.174 × FL) .

Which twin is usually bigger?

As expected, first-born twins had greater birth weight than second-born twins. With respect to height, first-born twins were slightly taller than second-born twins in childhood.

What is a good birth weight for twins?

While the average single baby weighs 7 pounds at birth, the average twin weighs 5.5 pounds. Triplets typically weigh 4 pounds each, and quads weigh 3 pounds each. Babies born at under 5.5 pounds are considered to have a low birth weight.

Can twins be born different sizes?

Most twin, triplet or more babies will be slightly different in size, but sometimes 1 baby is significantly smaller than the other/s. This is called 'selective' fetal growth restriction. Selective fetal growth restriction occurs in 10-20% of multiple pregnancies.

How is discordance of twins best measured?

Growth discordance can be estimated by measuring crown rump length (CRL: the distance measured from the top of the head to the bottom of the buttocks) at or before 12 weeks of gestation (Tai 2007).

Can you tell if twins are identical from ultrasound?

The only way of knowing for certain that your twins are identical is if, on an ultrasound scan, the ultrasound tech can see that your babies share an inner sac (chorion) with no dividing membrane (called monochorionic/monoamniotic). This means they are definitely identical.

When should MCDA twins be terminated?

Just like DC gestations, there are no high-quality studies to respond with great certainty the right time for terminate monochorionic pregnancies. Most specialists in large reference centers recommend delivery of monochorionic/diamniotic twins between 36 + 0 and 36 + 6 weeks.

What causes one twin to stop growing?

Selective intrauterine growth restriction (sIUGR) is a condition that occurs in twin pregnancies when one of the babies does not receive enough nourishment through the placenta to grow at a normal rate.

Can identical twins grow at different rates?

Because of the extreme similarity in their biological makeup, identical twins may react the same way to how your body is gestating. There may be little difference in their growth, but nature will always be a factor. Your twins may start to grow at different rates regardless of their status as identical twins.

Can a baby eat its twin in the womb?

Vanishing twin syndrome was first recognized in 1945. This occurs when a twin or multiple disappears in the uterus during pregnancy as a result of a miscarriage of one twin or multiple. The fetal tissue is absorbed by the other twin, multiple, placenta or the mother. This gives the appearance of a “vanishing twin.”