Neurological morbidity in monochorionic twins with selective fetal growth restriction.

IF 1.6 Q3 OBSTETRICS & GYNECOLOGY
Minerva obstetrics and gynecology Pub Date : 2023-12-01 Epub Date: 2022-06-22 DOI:10.23736/S2724-606X.22.05068-0
Tiemi M Paiva, Eduardo F Santana, Murilo F Casati, Edward Araujo Júnior
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引用次数: 0

Abstract

The increased risks of various obstetric, maternal and fetal comorbidities of monochorionic twin pregnancies are widely known. However, despite its high prevalence and significance, the assessment of neurological morbidity as more commonly in selective fetal growth restriction (sFGR) is concerned with more health care. This literature review aims to provide more information about such an assessment. To this end, retrospective cases of sFGR were studied in monochorionic twins, already diagnosed, classified and who had the recommended management, published between 2001 and 2018 in 17 scientific articles. In the assessment of fetal mortality, the highest risk of death of the restricted fetus was found in type 3 of sFGR, while type 2 sFGR was responsible for the highest death rates of both fetuses and also the lowest mean gestational age at delivery, 30.9 weeks. Regarding neurological morbidity, however, studies have shown a higher risk of brain damage in the habitually growing twin compared to the restricted one in the case of sFGR. This may be due to prematurity or intermittent diastolic flow on Doppler in type 2 and 3 of sFGR, however, statements about its pathophysiology still lack further studies.

选择性胎儿生长受限单绒毛膜双胞胎的神经系统疾病。
众所周知,单绒毛膜双胎妊娠的各种产科、孕产妇和胎儿合并症的风险增加。然而,尽管其高患病率和重要性,神经系统疾病的评估更常见于选择性胎儿生长受限(sFGR),但更多的是关注卫生保健。这篇文献综述的目的是提供更多关于这种评估的信息。为此,在2001年至2018年期间发表的17篇科学论文中,对已诊断、分类并采用推荐管理的单绒毛膜双胞胎中sFGR的回顾性病例进行了研究。在胎儿死亡率评估中,限制性胎儿的死亡风险最高的是3型sFGR,而2型sFGR导致两种胎儿的死亡率最高,而且分娩时平均胎龄最低,为30.9周。然而,在神经系统疾病方面,研究表明,在sFGR的情况下,习惯性生长的双胞胎与受限制的双胞胎相比,脑损伤的风险更高。这可能是由于2型和3型sFGR的早产或间歇性舒张期血流,然而,关于其病理生理的声明仍缺乏进一步的研究。
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来源期刊
Minerva obstetrics and gynecology
Minerva obstetrics and gynecology OBSTETRICS & GYNECOLOGY-
CiteScore
2.90
自引率
11.10%
发文量
191
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