Abstract:

In monocorionic pregnancies with selective intrauterine developmental limitation (sIUGR), the uneven division of the placenta and vascular anastomosis result in both fetuses may be negatively affected. In our study, we aimed at investigating the perinatal results of both large and small fetus in monocorionic pregnancies with sIUGR and non-sIUGR (non-sIUGR). The method was examined retrospective by 196 monocorionic twins pregnancy between January 2013 and January 2019. The cases were grouped as sIUGR and non-sIUGR pregnancies. Pregnancies with sIUGR were also grouped as those with normal umbilical current pattern and those with an abnormal umbilical current pattern. Perinatal results for large and small fetuses between groups were studied separately. The study found that 17.6 percent of the total of 153 monocorionic pregnancies included in the study were from sIUGR pregnancies and 82.4 percent (n=126) from non-sIUGR pregnancies. In 59.3% of developing pregnancies (n=16) the umbilical arterial current pattern was normal, while in 40.7% (n=11) an abnormal umbilical arterial current pattern was present. The preeclampsia rate in sIUGR pregnancies was significantly higher than in non-sIUGR pregnancies (25.9% vs. 11.1% p=0.042). In sIUGR pregnancies, the need for intensive care for both large and small newborns was significantly higher than in non-sIUGR pregnancies (p<0.001). Three of the newborns in sIUGR pregnancies (11.1%) were lost during the neonatal period. All of the lost newborns were small newborns in pregnancies with an abnormal umbilical arterial flow paterni. Pregnancies with selective intrauterine developmental limitation (sIUGR) are associated with a higher risk of perinatal results compared to non-sIUGR pregnancies. In developing pregnancies there is an increase in risk for the small fetus as well as the big fetus. More prospective studies are needed to determine whether this increased risk is associated with a higher pregnancy prematurity or whether it is a result of sIUGR.

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