OP15.02: Intertwin disparity in crown–rump length, gestational sac and yolk sac size and fetal heart rate at 7 weeks'gestation

Abstract

Objectives: To compare (1) absolute and (2) weight-specific blood flow volume of uterine arteries (UtA) in normal twin pregnancies to normal singleton pregnancies. Methods: Twelve twin pregnancies (10 dichorionic, two monochorionic) with normal UtA PI and normal weight at birth were included. UtA diameter and time-averaged maximum velocity were obtained to calculate flow (mL/min) and UtA flow/EFW (mL/min/kg) in each UtA. UtA flow was estimated by the formula Q = hV · πD2/4; a patient-specific coefficient, h, was obtained by an ad hoc mathematical model. Total UtA flow was calculated as a sum of right and left vessel flow volume. Twins’ UtA flow was expressed per unit EFW considering the sum of the two EFWs. Twins were compared to 48 normal age-matched singletons. Results: Gestational age at exam was similar in twins and in singletons (25.9 ± 6.4 vs. 25.2 ± 6.2 weeks, NS). UtA flow (mL/min) was significantly increased in twins (509.3 ± 240.7 mL/min) compared to singletons (337.2 ± 257.0 mL/min) (P = 0.04). UtA flow (mL/min) exponentially increased along gestation in twins and in singletons. The twins’ trend was above the third interquartile range of singletons’ reference values. UtA diameter was significantly increased in twins (0.33 ± 0.07 cm) than in singletons (0.28 ± 0.05 cm), while no differences in UtA mean velocity were observed (77.5 ± 29.9 vs. 76.7 ± 29.1 cm/sec, respectively, NS). UtA flow per EFW did not differ between twins and singletons (384.4 ± 198.6 vs. 460.9 ± 302.9 mL/min/kg, respectively, NS). Conclusions: (1) UtA flow volume (mL/min) in twin pregnancies was significantly increased. This was determined by larger vessel diameter, compared to singletons. (2) Each twin proved to share an amount of UtA flow per unit estimated fetal weight not significantly different from singletons.