Placental characteristics of selective intrauterine growth restriction with changing patterns in umbilical artery Doppler flow in monochorionic diamniotic twins.

Abstract

To compare the placental features between selective intrauterine growth restriction (sIUGR) patients, with dynamic classification (DC) and stable classifications (SC). A cohort study was conducted from 1st April 2013 to 1st April 2020, we recruited sIUGR patients who had delivered at our center and examined placental characteristics with dye injection. The primary outcome was placental characteristics. The prevalence of large artery-artery anastomosis (AAA) was significantly higher in sIUGR with DC than sIUGR with SC (88.2 vs. 46.6%, p=0.001). The total diameter of AAA was significantly larger in sIUGR with DC than sIUGR with SC [2.9 (1.4, 7.0) vs. 2.4 (0.3, 7.1)mm, p=0.032]. The total number of artery-vein anastomosis was significantly smaller in sIUGR with DC than sIUGR with SC [3(1,12) vs. 5 (1, 15), p=0.023]. The incidence of neonatal asphyxias of growth-restricted fetuses were higher in sIUGR with DC than sIUGR with SC (23.5 vs. 5.9%, p=0.033). Large AAA is probably associated to sIUGR with dynamic classification.