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Detection of chromosomal abnormalities, congenital abnormalities and transfusion syndrome in twins

Sperling, L.; Kill, C.; Larsen, L. U.; Brocks, V.; Wojdemann, K. R.; Qvist, I.; Schwartz, M.; Jörgensen, Connie LU ; Espersen, G. and Skajaa, K., et al. (2007) In Ultrasound in Obstetrics & Gynecology 29(5). p.517-526
Abstract
Objective To evaluate the outcome of screening for structural malformations in twins and the outcome of screening for twin-twin transfusion syndrome (TTTS) among monochorionic twins through a number of ultrasound scans from 12 weeks' gestation. Methods Enrolled into this prospective multicenter observational study were women with twin pregnancies diagnosed before 14 + 6 gestational weeks. The monochorionic pregnancies were scanned every second week until 23 weeks in order to rule out early TTTS. All pregnancies had an anomaly scan in week 19 and fetal echocardiography in week 21 that was performed by specialists in fetal echocardiography. Zygosity was determined by DNA analysis in all twin pairs with the same sex. Results Among the 495... (More)
Objective To evaluate the outcome of screening for structural malformations in twins and the outcome of screening for twin-twin transfusion syndrome (TTTS) among monochorionic twins through a number of ultrasound scans from 12 weeks' gestation. Methods Enrolled into this prospective multicenter observational study were women with twin pregnancies diagnosed before 14 + 6 gestational weeks. The monochorionic pregnancies were scanned every second week until 23 weeks in order to rule out early TTTS. All pregnancies had an anomaly scan in week 19 and fetal echocardiography in week 21 that was performed by specialists in fetal echocardiography. Zygosity was determined by DNA analysis in all twin pairs with the same sex. Results Among the 495 pregnancies the prenatal detection rate for severe structural abnormalities including chromosomal aneuploidies was 83% by the combination of a first-trimester nuchal translucency scan and the anomaly scan in week 19. The incidence of severe structural abnormalities was 2.6% and two-thirds of these anomalies were cardiac. There was no significant difference between the incidence in monozygotic and dizygotic twins, nor between twins conceived naturally or those conceived by assisted reproduction. The incidence of TTTS was 23% from 12 weeks until delivery, and all those monochorionic twin pregnancies that miscarried had signs of TTTS. Conclusion Twin pregnancies have an increased risk of congenital malformations and one out of four monochorionic pregnancies develops TTTS. Ultrasound screening to assess chorionicity and follow-up of monochorionic pregnancies to detect signs of TTTS, as well as malformation screening, are therefore essential in the antenatal care of twin pregnancies. Copyright (c) 2007 IS UOG. Published by John Wiley & Sons, Ltd. (Less)
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Contribution to journal
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published
subject
keywords
ultrasonography, transfusion syndrome, twin-twin, twin pregnancy, fetal abnormalities, multiple pregnancy, zygosity
in
Ultrasound in Obstetrics & Gynecology
volume
29
issue
5
pages
517 - 526
publisher
John Wiley & Sons
external identifiers
  • wos:000246878800007
  • scopus:34249653964
ISSN
1469-0705
DOI
10.1002/uog.3918
language
English
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yes
id
593d3fb6-8799-4479-becf-3941f0e9e11d (old id 651256)
date added to LUP
2007-12-19 09:42:45
date last changed
2017-08-20 04:27:08
@article{593d3fb6-8799-4479-becf-3941f0e9e11d,
  abstract     = {Objective To evaluate the outcome of screening for structural malformations in twins and the outcome of screening for twin-twin transfusion syndrome (TTTS) among monochorionic twins through a number of ultrasound scans from 12 weeks' gestation. Methods Enrolled into this prospective multicenter observational study were women with twin pregnancies diagnosed before 14 + 6 gestational weeks. The monochorionic pregnancies were scanned every second week until 23 weeks in order to rule out early TTTS. All pregnancies had an anomaly scan in week 19 and fetal echocardiography in week 21 that was performed by specialists in fetal echocardiography. Zygosity was determined by DNA analysis in all twin pairs with the same sex. Results Among the 495 pregnancies the prenatal detection rate for severe structural abnormalities including chromosomal aneuploidies was 83% by the combination of a first-trimester nuchal translucency scan and the anomaly scan in week 19. The incidence of severe structural abnormalities was 2.6% and two-thirds of these anomalies were cardiac. There was no significant difference between the incidence in monozygotic and dizygotic twins, nor between twins conceived naturally or those conceived by assisted reproduction. The incidence of TTTS was 23% from 12 weeks until delivery, and all those monochorionic twin pregnancies that miscarried had signs of TTTS. Conclusion Twin pregnancies have an increased risk of congenital malformations and one out of four monochorionic pregnancies develops TTTS. Ultrasound screening to assess chorionicity and follow-up of monochorionic pregnancies to detect signs of TTTS, as well as malformation screening, are therefore essential in the antenatal care of twin pregnancies. Copyright (c) 2007 IS UOG. Published by John Wiley & Sons, Ltd.},
  author       = {Sperling, L. and Kill, C. and Larsen, L. U. and Brocks, V. and Wojdemann, K. R. and Qvist, I. and Schwartz, M. and Jörgensen, Connie and Espersen, G. and Skajaa, K. and Bang, J. and Tabor, A.},
  issn         = {1469-0705},
  keyword      = {ultrasonography,transfusion syndrome,twin-twin,twin pregnancy,fetal abnormalities,multiple pregnancy,zygosity},
  language     = {eng},
  number       = {5},
  pages        = {517--526},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in Obstetrics & Gynecology},
  title        = {Detection of chromosomal abnormalities, congenital abnormalities and transfusion syndrome in twins},
  url          = {http://dx.doi.org/10.1002/uog.3918},
  volume       = {29},
  year         = {2007},
}