Dichorionic Twins Research Articles

Prenatal diagnosis of chorioangioma – series of cases and management options

IntroductionLarge chorioangioma is one of the causes of fetal anemia and heart failure as well as preterm deliveries.AimThe aim of the study was to assess the clinical implications of prenatal diagnosis of chorioangioma and present new treatment options: laser coagulation and embolisation of feeding vessles.Material and methodsChorioangioma was diagnosed in 5 patients (4 singleton pregnancies and 1 dichorionic twin pregnancy). Ultrasound examinations and routine follow-up were performed in these women to detect possible fetal and maternal complications caused by the placental tumor. Pregnancy management, including invasive procedures and outcome, was analyzed.Results and discussionA high proportion of the patients in the study group (80%) required prenatal intervention due to the fetal heart failure or polyhydramnios. Three patients underwent laser coagulation of superficial supplying vessels; embolization of the deep vessel in the tumor was performed in 1 woman with dichorionic twin gestation. One woman opted for termination of pregnancy following an ineffective laser procedure. One pregnancy (20%) was uncomplicated and managed conservatively. In the group of 4 patients after prenatal treatment, all women gave birth to viable neonates; however, in the case of twin gestation, the affected fetus expired.ConclusionsPrenatal diagnosis of chorioangioma should entail a detailed follow-up of the patient to detect pregnancy complications early enough to introduce intrauterine treatment, preventing intrauterine fetal demise.

The effectiveness of cervical cerclage in twin pregnancies with a mid-trimester short cervix: A retrospective cohort study

ObjectiveTo analyze the effectiveness of cerclage in twin pregnancies with a short cervix. Study designRetrospective cohort study performed in two University Institutions in Valencia (Spain) with two different protocols for the management of asymptomatic dichorionic diamniotic twin pregnancies with mid-trimester cervical length ≤ 25 mm: treatment with indomethacin, antibiotics and cerclage (cerclage group) (N = 43) versus expectant management (control group) (N = 37). ResultsThe initial cervical length was similar in both groups but detection of a short cervix was performed earlier in the cerclage group (21.6 vs 24.1 weeks, p < 0.001). Women with cerclage had a greater pregnancy latency (12.5 vs. 7.7 weeks, p < 0.001); higher gestational age at delivery (34.1 vs. 31.8 weeks, p < 0.04); less spontaneous preterm birth (SPB) < 28 weeks (11.6 % vs 37.8 %, p < 0.009); higher birthweight (2145 vs 1733 g, p < 0.001); lower birthweight < 1500 g (12.5 % vs 40.0 %, p < 0.001); less admissions to the neonatal intensive care unit (NICU) (24.1 % vs 43.3 %, p < 0.03); shorter stay at NICU (25.6 vs 49.4 days, p < 0.02); lower respiratory distress requiring mechanical ventilation (14.9 % vs 36.5 %, p < 0.02); fewer patent ductus arteriosus (8.9 % vs 26.9 %, p < 0.008); and lower composite adverse neonatal outcome (26.6 % vs. 44.8 %, p < 0.03). Cerclage and gestational age at diagnosis were the only independent predictors of SPB < 32 and < 28 weeks by multivariate analysis. The cumulative data in the literature show promising beneficial effects of cerclage. ConclusionOur data suggest that cerclage in asymptomatic twin pregnancies with a short cervix may reduce the earliest SPB and may improve neonatal outcome.

Clinical experience with postpartum treatment of a patient with arteriovenous malformation of uterine vessels

Uterine arteriovenous malformation is a rare vascular dysplasia where the uterine veins communicate with the branches of arteries of varying calibers. Patient K., a 37-years-old patient, presented with genital tract bleeding. Her medical history included operative labor at 37 weeks with dichorionic diamniotic twins, with the placental site on the posterior uterine wall exhibited firm attachment. The uterine cavity walls were scraped, and the bleeding vessel in the placental site was sutured. The blood loss amounted to 750 mL, and reinfusion was conducted. Fourteen days after giving birth, a heavy bloody discharge with blood clots from the genital tract occurred. The blood tests revealed no abnormalities. Echography detected multiple tubular structures that were anechoic on the posterior wall of the uterus, from the endometrium to the serosa, with the CDC mode blood flow. Magnetic resonance angiography revealed hypervascularization with premature arteriovenous discharge. Superselective embolization was performed on uterine artery afferents, and complete blood flow reduction was achieved, leading to the cessation of bleeding. On postoperative day 17, the patient experienced considerable bloody discharge from the genital tract, causing the hemoglobin level to decrease to 88 g/L. The presence of an arteriovenous malformation in the uterine vessels accompanied by ineffective embolization necessitated uterine extirpation. The postoperative phase was uneventful, and the patient was discharged from the hospital in satisfactory condition, with no evidence of anemia (hemoglobin, 115 g/L).

Epidemiology and factors associated with preterm births in multiple pregnancy: a retrospective cohort study

ObjectiveMultiple pregnancies carry an increased risk of maternal and perinatal complications, notably prematurity. Few studies have evaluated the risk factors for preterm births in multiple pregnancies within the Thai population. This study aims to ascertain maternal and perinatal outcomes and identify factors linked to preterm births in multiple pregnancies.MethodsThis study was carried out at Khon Kaen University, Faculty of Medicine, Department of Obstetrics and Gynecology in Thailand. We reviewed the medical records of women with multiple pregnancies who delivered at a gestational age of more than 20 weeks between January 1, 2012 and December 31, 2021. We excluded patients with incomplete data or those for whom data were missing.ResultsOut of 21,400 pregnancies, 427 were multiple pregnancies, constituting approximately 1.99%. Over the ten-year period, 269 multiple pregnancies (65.1%) resulted in preterm births. Of these, 173 (64.3%) were monochorionic twins, and 96 (35.7%) were dichorionic twins. Monochorionic twins had a notably higher rate of preterm delivery (AOR, 2.06; 95%CI 1.29—3.30). Vaginal delivery was observed in 7.9% of the cases, while cesarean sections were performed for both twins in 91.5% of cases. In 0.5% of the cases, only the second twin was delivered by cesarean section. In terms of neonatal outcomes, 160 infants (19.4%) weighed less than 1,500 g at birth, and there were 78 perinatal deaths (9.4%). Birth asphyxia was noted in 97 cases (20.2%) among monochorionic twins and in 28 cases (8.1%) for dichorionic twins.ConclusionThe prevalence of multiple pregnancies was 1.99%, with 65.1% resulting in preterm births. Neonatal complications were notably more frequent in monochorionic twins. Monochorionic placenta and antepartum complications emerged as significant risk factors for preterm birth.

#57 : A Prediction Model of Low Birthweight in Singleton Pregnancies Reduced from Dichorionic Twin Pregnancies

Background and Aims: The incidence of twin pregnancies has risen over the last few decades, mainly attributed to assisted reproduction techniques (ART). Fetal reduction (FR) can significantly reduce low birthweight (LBW) risk in twins. However, the LBW risk is still higher in singletons reduced from twins than for primary singletons. Many factors, such as maternal factors, FR timing and approach may affect LBW risks after FR and no relevant prediction models have been reported to date. The main objective of this study is to develop a nomogram to predict LBW risk in singleton pregnancies reduced from dichorionic (DC) twins. Method: We retrospectively reviewed and analyzed the data on women with (DC) twin pregnancies who underwent FR in Women’s Hospital, Zhejiang university, School of medicine in July 2005 to August 2021. Logistic LASSO regression was used to identify the most relevant variables associated with LBW. The nomogram was constructed and receiver operating characteristic (ROC) curve, Hosmer-Lemeshow test, and decision clinical analysis were used for model performances assessment and visualization. The model was evaluated by cohorts produced by 500 resampling bootstrap analysis to testify the stability. Results: A total of 471 patients were enrolled in the analysis. At last, seven independent predictive factors for LBW were identified and integrated to construct the nomograms, including maternal height, nulliparous, conception mode, reasons for FR, gestational age at FR, gestational diabetes, pregnancy hypertensive disease. The AUC of our prediction model was 0.793, which was validated by internal (AUC 0.762) confirmation with bootstrap analysis. The nomogram had well-fitted calibration curves. Decision curve analysis demonstrated that the nomogram was clinically useful. Conclusion: We made the first attempt to develop a reliable predictive nomogram for the risk of LBW in DC twin pregnancies reduced to singletons, providing a useful guide for clinicians and patients in making appropriate FR decisions.

Can growth in dichorionic twins be monitored with individualized growth assessment?

To characterize fetal growth in dichorionic twins using individualized growth assessment (IGA), a method based on individual growth potential estimates. This secondary analysis included 286 fetuses/neonates from 143 dichorionic twin pregnancies that were part of the ESPRiT (Evaluation of Sonographic Predictors of Restricted Growth in Twins) study. The sample was subcategorized according to birth weight into appropriate-for-gestational-age (AGA) (n = 243) and small-for-gestational-age (SGA) (n = 43) cohorts. Serial biometric scans evaluating biparietal diameter, head circumference (HC), abdominal circumference, femur diaphysis length and estimated weight at 2-week intervals were used to evaluate fetal growth, while measurements of birth weight, crown-heel length and HC determined neonatal growth outcome. Six abnormalities (hypoxic ischemic encephalopathy, periventricular leukomalacia, necrotizing enterocolitis, respiratory distress, sepsis and death) constituted the evaluated adverse neonatal outcomes (ANO). IGA was used to: evaluate differences in second-trimester growth velocities between singletons (from a published dataset) and dichorionic twins (138 AGA twins with normal third-trimester growth); describe the degree to which actual third-trimester growth in twins followed expected growth (111 AGA twins, normal fetal growth and neonatal growth outcomes); determine if the fetal growth pathology score 1 (-FGPS1) could detect, quantify and classify twin growth pathology (224 AGA, 42 SGA); and assess the relationship between -FGPS1 and ANO (24 SGA twins with progressive growth restriction confirmed by abnormal neonatal growth outcome). The differences in second-trimester growth velocity between singletons and twins (means and variances) were small and not statistically significant. Percent deviations from the expected third-trimester size trajectories were within the 95% reference ranges derived from singletons at 95.7% (1677/1752) of timepoints studied. Abnormal growth was detected in 37.9% of AGA twins and 85.7% of SGA twins. Growth restriction was more heterogeneous in AGA twins, while in SGA twins progressive growth restriction was the principal type (66.7%). -FGPS1 patterns previously defined in singletons classified 97.5% of pathological twin cases. In our most severe form of growth restriction (progressive), there were only three (12.5%) ANOs related to growth abnormalities, all in cases with -FGPS1 values more negative than -2.0%. Using these criteria, the frequency of ANO was 33%. With respect to growth, dichorionic twins can be considered as two singletons in the same uterus. Normally growing dichorionic twins have the same growth potential as singletons with normal growth outcome. These twins also follow expected third-trimester growth trajectories with the same precision as do singletons. Third-trimester growth pathology can be detected, quantified and classified using -FGPS1 as in singletons. Limited evidence of a relationship between fetal growth abnormalities and adverse neonatal outcome was found. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Incidence and Perinatal Outcomes of Twin Pregnancy in Tertiary Healthcare Facility, Odisha, India

Background: Assisted reproductive technology has resulted in a progressive rise in the incidence of twin pregnancies, which affect both mother and child in terms of antepartum complications. Objective: To assess the perinatal outcomes of twin pregnancies and the influence of chorionicity on them in a tertiary healthcare facility. Methods: It is a hospital-based cross-sectional study that was carried out in the Obstetrics and Gynecology Department of S.C.B. Medical College Hospital, Cuttack, during the period from 2013 to 2015. All mothers having twin pregnancies (with 28 weeks of completed gestation) admitted to the antenatal (ANC) ward and labor room during this period were taken as a study group, and written informed consent was taken after explaining the details of the study. Results: A total of 150 cases are identified; among them, 98 cases (65.33%) are dichorionic diamniotic, 50 cases (33.33%) are monochorionic diamniotic, and 2 cases (1.33%) are monochorionic and monoamniotic pregnancies. The majority (66%) of the twin pregnancies were between 35-38 wks of gestational age at the onset of labor. It is also observed that macerated births, stillbirths, and neonatal deaths are higher in mono-chorionic twins as compared to dichorionic twins. Conclusions: Twin pregnancies carry a greater risk of adverse outcomes, especially perinatal mortality and neonatal morbidity, in monochorionic twins than dichorionic twins. Good antenatal care, early diagnosis of chorionicity, and antepartum assessment of placentation will prevent mortality and morbidity.

Higher risk of preterm twin delivery among shorter nulliparous women

ObjectiveTo determine if maternal height in nulliparous women influences pregnancy results in twin pregnancies. Material and methodsRetrospective cohort analysis evaluating twin pregnancies followed at Centro Hospitalar Universitário Lisboa Central, between 1995 and 2020. Of the 2900 pregnancies followed in that period, 886 nulliparous women with dichorionic twin pregnancies were selected. Two groups were considered: A - maternal height <163 cm (<Q2) (n = 436) and B - maternal height ≥167 cm (≥Q3) (n = 234), The following results were compared: Age, body mass index (BMI), premature contractions, premature rupture of membranes (PROM), hypertensive disorders, gestational diabetes, gestational age at birth, delivery <28, <32, <34, < 36, ≥37 weeks (wks), average weight of newborns, very low birth weight, low birth weight, cesarean section rate, stillbirths, five minute Apgar score, neonatal death and perinatal death. Result(s)PTB rates decreased along increasing maternal height. The comparison between group A and group B revealed no statistically significant differences in maternal characteristics (age, mode of conception - spontaneous or ART pregnancies, or BMI). Statistically significant differences were found in mean gestational age at birth (35.1 ± 1.8 vs. 36.0 ± 2.6 wks), PTB rates < 32, 34 and 36 wks, OR: 3.2, 2.3 and 2.4 respectively, p < 0.01. Shorter women had a 1.7× and 2.6× increased risk for significantly low (<2500 g) and very low (<1500 g) newborn birth weight (BW), respectively, and a 40 % increased risk of Cesarian delivery. No significant differences were shown with respect to stillbirths, neonatal and perinatal deaths, which had a low incidence in this study. In ART pregnancies we found the same results regarding PTB rates and newborn birthweight in shorter women. In Logistic Regression analysis, maternal height <Q2 is an independent risk factor for PTB under 32, 34 and 36 wks, adjusted OR: 2.0. 2.2 and 2.4, respectively, 95 % CI 1.1–3.7, p = 0.021. ConclusionIncreased pregnancy risk in nulliparous shorter women should be taken into consideration in double embryo transfers.

Birth outcomes of twins after multifetal pregnancy reduction compared with primary twins

BackgroundThe introduction of assisted reproductive technology and the trend of increasing maternal age at conception have been responsible for a significant rise in the incidence of multiple pregnancies. Multiple pregnancies bear several inherent risks for both mother and child. These risks increase with plurality and type of chorionicity. Multifetal pregnancy reduction is the selective abortion of one or more fetuses to improve the outcome of the remaining fetus(es) by decreasing the risk of premature birth and other complications. ObjectiveThis study compares the birth outcomes of trichorionic triplets reduced to twins with trichorionic triplets and primary dichorionic twins. The added value of this study is the comparison with an additional control group, namely primary dichorionic twins. Study designThis is a retrospective cohort study. Data from January 1990 till November 2016 were collected from the East Flanders Prospective Twin Survey, one of the largest European multiple birth registries. Eigthy-five trichorionic triplet pregnancies (170 neonates) undergoing multifetal pregnancy reduction (MPR) to twins were compared to 5,093 primary dichorionic twin pregnancies (10,186 neonates) and 104 expectantly managed trichorionic triplet pregnancies (309 neonates). The outcomes are gestational age at delivery, birth weight, and small for gestational age. ResultsPregnancy reduction from triplets to twins is associated with a higher birth weight (+365.44 g, 95%CI [222.75, 508.14 g], p < .0001) and longer gestational age (1.7 weeks, 95%CI [0.93, 2.46], p< .0001) compared to ongoing trichorionic triplets, adjusted for sex, parity, method of conception, birth year, and maternal age. A trend towards a lower risk of SGA is observed. Reduced triplets have, on average, a lower birth weight (-263.12 g, 95%CI [-371.80, -154.44 g], p < .0001), and a shorter gestational age (-1.13 weeks, 95%CI [-1.70, -0.56], p=0.0001) compared to primary twins. No statistically significant difference between primary twins and reduced triplets that reach 32 weeks of gestation is observed. ConclusionMultifetal pregnancy reduction from trichorionic triplets to twins significantly improves birth outcomes. This suggests that MPR of trichorionic triplets to twins is medically justifiable. However, the birth outcomes of primary twins before 32 weeks of gestation are still better in comparison with reduced triplets. The process of MPR includes at least one fetal death by definition, therefore prevention of higher-order pregnancies is preferred.

A case of dichorionic twin reversed arterial perfusion sequence with prenatal diagnosis of vascular anastomosis in the first trimester

A case of dichorionic twin reversed arterial perfusion sequence with prenatal diagnosis of vascular anastomosis in the first trimester

The NICHD Fetal 3D Study: A Pregnancy Cohort Study of Fetal Body Composition and Volumes.

There's a paucity of robust normal fractional limb and organ volume standards from a large and diverse ethnic population. The Fetal 3D Study was designed to develop research and clinical applications for fetal soft tissue and organ volume assessment. The NICHD Fetal Growth Studies (2009-2013) collected 2D and 3D fetal volumes. In the Fetal 3D Study (2015-2019), sonographers performed longitudinal 2D and 3D measurements for specific fetal anatomical structures in research ultrasounds of singletons and dichorionic twins. The primary aim was to establish standards for fetal body composition and organ volumes, overall and by maternal race/ethnicity, and determine whether these standards vary for twins versus singletons. We describe the study design, methods, and details about reviewer training. Basic characteristics of this cohort, with their corresponding distributions of fetal 3D measurements by anatomical structure, are summarized. This investigation is responsive to critical data gaps in understanding serial changes in fetal subcutaneous fat, lean body mass, and organ volume in association with pregnancy complications. In the future, this cohort can answer critical questions regarding the potential influence of maternal characteristics, lifestyle factors, nutrition, and biomarker and chemical data on longitudinal measures of fetal subcutaneous fat, lean body mass, and organ volumes.

Nutritional Intake in Dichorionic Twin Pregnancies: A Descriptive Analysis of a Multisite United States Cohort.

Twin gestations have greater nutritional demands than singleton gestations, yet dietary intakes of women with twin gestations have not been well described. In a prospective, multi-site US study of 148 women with dichorionic twin gestations (2012-2013), we examined longitudinal changes in diet across pregnancy. Women completed a food frequency questionnaire during each trimester of pregnancy. We examined changes in means of total energy and energy-adjusted dietary components using linear mixed effects models. Mean energy intake (95% CI) across the three trimesters was 2010kcal/day (1846, 2175), 2177kcal/day (2005, 2349), 2253kcal/day (2056, 2450), respectively (P = 0.01), whereas the Healthy Eating Index-2010 was 63.9 (62.1, 65.6), 64.5 (62.6, 66.3), 63.2 (61.1, 65.3), respectively (P = 0.53). Women with twin gestations moderately increased total energy as pregnancy progressed, though dietary composition and quality remained unchanged. These findings highlight aspects of nutritional intake that may need to be improved among women carrying twins.

Prevalence and detection rate of major congenital heart disease in twin pregnancies in Denmark.

To investigate the national prevalence and prenatal detection rate (DR) of major congenital heart disease (mCHD) in twin pregnancies without twin-to-twin transfusion syndrome (TTTS)-associated CHD in a Danish population following a standardized prenatal screening program. This was a national registry-based study of data collected prospectively over a 10-year period. In Denmark, all women with a twin pregnancy are offered standardized screening and surveillance programs in addition to first- and second-trimester screening for aneuploidies and malformation, respectively: monochorionic (MC) twins every 2 weeks from gestational week 15 and dichorionic (DC) twins every 4 weeks from week 18. The data were retrieved from the Danish Fetal Medicine Database and included all twin pregnancies from 2009-2018, in which at least one fetus had a pre- and/or postnatal mCHD diagnosis. mCHD was defined as CHD requiring surgery within the first year of life, excluding ventricular septal defects. All pregnancy data were pre- and postnatally validated in the local patient files at the four tertiary centers covering the entire country. A total of 60 cases from 59 twin pregnancies were included. The prevalence of mCHD was 4.6 (95% CI, 3.5-6.0) per 1000 twin pregnancies (1.9 (95% CI, 1.3-2.5) per 1000 live births). The prevalences for DC and MC were 3.6 (95%CI, 2.6-5.0) and 9.2 (95%CI, 5.8-13.7) per 1000 twin pregnancies, respectively. The national prenatal DR of mCHD in twin pregnancies for the entire period was 68.3%. The highest DRs were in cases with univentricular hearts (100%) and the lowest with aortopulmonary window, total anomalous pulmonary venous return, Ebstein's anomaly, aortic valve stenosis and coarctation of the aorta (0-25%). Mothers of children with prenatally undetected mCHD had a significantly higher body mass index (BMI) compared to mothers of children with a prenatally detected mCHD (median, 27 kg/m2 and 23 kg/m2 , respectively; P = 0.02). The prevalence of mCHD in twins was 4.6 per 1000 pregnancies and was higher in MC than DC pregnancies. The prenatal DR of mCHD in twin pregnancies was 68.3%. Maternal BMI was higher in cases of prenatally undetected mCHD. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

The role of estimated fetal weight discordance in dichorionic twin pregnancies.

Evaluation of relative fetal growth in the form of estimated fetal weight discordance (EFWd) is a necessary element of any ultrasound examination in twin pregnancies. It is one of the criteria for the diagnosis of selective fetal growth restriction (sFGR) according to the most established worldwide guidelines. Apart from the effectiveness of this parameter for the diagnosis of sFGR, it may also be used as an independent factor for risk stratification of neonatal and maternal complications. Furthermore, numerous studies have proven the greater prognostic value of EFWd in dichorionic pregnancies, which may result from differences in the pathogenesis of fetal growth abnormalities in mono- and dichorionic pregnancies. Because of the variability of this parameter throughout pregnancy, there is an ongoing discussion regarding replacing or individualizing it with percentile charts. An additional element, complementary to EFWd in assessing the risk of complications in twin pregnancies is the use of this measurement in combination with Doppler assessment, which increases its predictive value. The use of EFWd as one of the factors influencing care and decision-making in dichorionic twin pregnancies seems to be a simple and effective method, however, further research assessing the use and possible applications of this indicator is necessary.

EXIT-to-airway for obstructing fetal neck masses: a singular methodology for monochorionic and dichorionic twin pregnancies

INTRODUCTION: Fetal airway obstruction in one twin of a diamniotic pregnancy presents unique challenges. Very few cases of Ex-Utero-Intrapartum-Treatment (EXIT) procedures for twin pregnancy have been reported and only in dichorionic pregnancies. We report a singular methodology for EXIT-to-airway procedures in two pregnancies involving monochorionic and dichorionic twins. CASE PRESENTATION: Two cases of EXIT-to-airway in twin pregnancies were performed in 2018-2019 at a regional fetal treatment center. Case 1 involved a giant cervical teratoma in a monochorionic-diamniotic twin pregnancy with preterm labor at 29 weeks. Case 2 involved a dichorionic-diamniotic pregnancy with a large cervical lymphatic malformation with preterm labor at 36 weeks. In each case, the polyhydramnios caused the affected twin’s amniotic sac to be the presenting sac for the surgical approach. Bronchoscopy and successful intubation was completed after 22 and 10 minutes of uteroplacental bypass, respectively. The bystander twins were delivered second without intubation and resuscitated without perinatal distress. CONCLUSION: EXIT-to-airway appears to be a reasonable option for twins including monochorionic pregnancies, via delivery of the affected twin first followed by delivery of the bystander twin. Thoughtful preparation and counseling by an experienced multidisciplinary team permits an EXIT-to-airway approach for twin pregnancies even in an emergent setting.

OC13.01: Enhancing prenatal risk assessment: atypicality Index (AcFTS) as an adjunct to the combined first trimester screening in dichorionic twins*

OC13.01: Enhancing prenatal risk assessment: atypicality Index (AcFTS) as an adjunct to the combined first trimester screening in dichorionic twins*

OP11.03: Risk of fetal loss after invasive prenatal testing in dichorionic diamniotic twin pregnancies: a Danish national cohort study from 2008 to 2018

OP11.03: Risk of fetal loss after invasive prenatal testing in dichorionic diamniotic twin pregnancies: a Danish national cohort study from 2008 to 2018

EP14.01: The effect of fetal growth restriction on maternal pre‐eclampsia in discordant dichorionic twin

EP14.01: The effect of fetal growth restriction on maternal pre‐eclampsia in discordant dichorionic twin

OC13.08: Obstetric outcomes of dichorionic twins in IVF patients with confirmed normal uterine cavity versus those who conceived spontaneously

OC13.08: Obstetric outcomes of dichorionic twins in IVF patients with confirmed normal uterine cavity versus those who conceived spontaneously

EP14.11: The impact of fetal growth restriction on neonatal adverse outcomes in discordant dichorionic twins

EP14.11: The impact of fetal growth restriction on neonatal adverse outcomes in discordant dichorionic twins