Abstract
OBJECTIVE:The aim of the present study was to compare the placental weight and birth weight/placental weight ratio for intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins.METHODS:This was a retrospective analysis of placentas from twin pregnancies. Placental weight and the birth weight/placental weight ratio were compared in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. The association between cord insertion type and placental lesions in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins was also investigated.RESULTS:A total of 105 monochorionic (intrauterine growth restriction=40; non-intrauterine growth restriction=65) and 219 dichorionic (intrauterine growth restriction=57; non-intrauterine growth restriction=162) placentas were analyzed. A significantly lower placental weight was observed in intrauterine growth-restricted monochorionic (p=0.022) and dichorionic (p<0.001) twins compared to non-intrauterine growth-restricted twins. There was no difference in the birth weight/placental weight ratio between the intrauterine growth restriction and non-intrauterine growth restriction groups for either monochorionic (p=0.36) or dichorionic (p=0.68) twins. Placental weight and the birth weight/placental weight ratio were not associated with cord insertion type or with placental lesions.CONCLUSION:Low placental weight, and consequently reduced functional mass, appears to be involved in fetal growth restriction in monochorionic and dichorionic twins. The mechanism by which low placental weight influences the birth weight/placental weight ratio in intrauterine growth-restricted monochorionic and dichorionic twins needs to be determined in larger prospective studies.
Highlights
The placenta is a specialized organ of pregnancy that supports fetal growth and development
The present study demonstrated that overall placental weight is significantly lower in MC and DC Intrauterine growth restriction (IUGR) twins compared to nIUGR twins, but there was no difference in the overall birth weight to placental weight ratio (BW/PW) ratio
For births at 32 to 34 weeks, IUGR MC twins had a significantly lower placental weight compared to their nIUGR counterparts, and these twins were delivered earlier due to the low placental reserve for fetal nutrition
Summary
The placenta is a specialized organ of pregnancy that supports fetal growth and development. Recent publications have indicated the importance of reference values for singleton and twin placental weight and of the relationship between placental weight and fetal growth (1-3). There is a positive relation between birth weight and placental weight for twins (4). Compared to singletons, twins have lower birth weights and smaller placentas (2,5). Few studies have distinguished placental weight in dichorionic (DC) and monochorionic (MC) twin pregnancies (1,3,6), and they have reported conflicting results; Pinar et al did not observe a difference in placental weight between MC and DC twins (1), whereas De Paepe et al reported a lower placental weight and fetal:placental weight ratio in MC compared to DC twins (3)
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