V. Stagnati

Rapid cervical phIGFBP-1 test in asymptomatic twin pregnancies: role in mid-pregnancy prediction of spontaneous preterm delivery.

This study aimed to assess the accuracy of a second‐trimester rapid cervical phosphorylated insulin‐like growth factor binding protein‐1 (phIGFBP‐1) test to predict spontaneous preterm delivery in asymptomatic twin pregnancies.

Outcome of monochorionic diamniotic twin pregnancies followed at a single center

We aim to evaluate the outcome of a cohort of monochorionic diamniotic twin pregnancies followed from the first trimester onwards at a single center.

Early prediction of twin-to-twin transfusion syndrome: systematic review and meta-analysis.

To assess the role of first‐ and early second‐trimester markers in the prediction of twin‐to‐twin transfusion syndrome (TTTS) in monochorionic twin pregnancies.

Cervical length measurement at mid gestation to predict spontaneous preterm birth in asymptomatic triplet pregnancies

To assess the predictive value of sonographic cervical‐length (CL) measurement in mid‐gestation for spontaneous preterm birth (PTB) in asymptomatic triplet pregnancy.

Pregnancy outcome and long-term follow-up of fetuses with isolated increased NT: a retrospective cohort study

Abstract Objective: To assess the prevalence of associated findings, diagnosed either prior to or after birth, among fetuses with increased nuchal translucency (NT) and normal karyotype and to investigate the prevalence of children under therapy at school age, among cases confirmed to be isolated both prior to and after birth. Methods: Retrospective cohort study of all singleton pregnancies were referred for the 1st trimester screening for Down syndrome between January 2004 and December 2006. Cases with NT >95th percentiles who undertook fetal karyotype were analyzed. We evaluated the prevalence of the following: (i) abnormal fetal karyotype, (ii) associated structural abnormalities, (iii) genetic syndromes, and (iv) children needing treatment (i.e. medications or psychopedagogical intervention) at school age. Results: There were 19 106 women screened for Down syndrome. Among them, 846 (4.4%) had a NT >95th centile, of whom 541 (64.0%) undertook fetal karyotyping, 422 (78.0%) had normal karyotype, two (0.5%) opted for termination of pregnancy, and four (1.0%) ended in miscarriages. Among the 384 cases thought to be “normal” prior to birth, 14 (3.6%) were lost at follow-up and 10 (2.7%) had an associated abnormality diagnosed postnatally. Among the cases confirmed to be isolated, 10/270 (3.7%) were under treatment at the time of telephonic interview with parents. Conclusions: Parents should be informed that fetuses with increased NT and normal karyotype need detailed ultrasound scans during pregnancy and detailed pediatric evaluation at birth; if these are normal, the risk from adverse outcome at school age is the same as for general population.

Crown-rump length: are they different or similar after homologous vs heterologous oocyte/embryo donation?

Iuculano. CRL after homologous vs heterologous oocyte/embryo donation. Am J Obstet Gynecol 2017. INTRODUCTION: Pregnancies conceived after heterologous oocyte/embryo donation present a unique opportunity for understanding the biology of gestations in which there is a semi-allograft (ie, homologous embryo donation) vs a total allograft when the oocyte of the embryo does not share genetic material with the mother. Studies in fetal growth have focused on the effect of maternal characteristics (eg, age, anthropometric features such as maternal height and body mass index [BMI], etc) on fetal size and growth in the second and third trimesters. These factors are thought to play a less important role in determining changes in fetal bodily dimensions in the first trimester (ie, crown-rump length [CRL]).The objective of this study was to determine whether there are differences in CRL in conceptuses resulting from homologous vs heterologous oocyte/embryo donation. This study design will allow us to determine whether the changes reported in fetal size and growth after assisted reproductive techniques (ARTs) are attributable to maternal age, immunological nature of the pregnancy (semi-allograft vs allograft), or other factors.

Intertwin discrepancy in middle cerebral artery peak systolic velocity and third-trimester fetal growth restriction in monochorionic-diamniotic twin pregnancy: MCA-PSV in MCDA twin pregnancies

To assess the role of intertwin discrepancy in middle cerebral artery peak systolic velocity (MCA‐PSV) for the prediction of late selective intrauterine growth restriction (sIUGR) at birth and birth weight discrepancy of > 25% (BW‐25) in otherwise uncomplicated monochorionic–diamniotic (MCDA) twin pregnancies.

Inter‐twin discrepancy in middle cerebral artery peak systolic velocity and pregnancy outcome in monochorionic diamniotic twin pregnancies

To assess the role of intertwin discrepancy in middle cerebral artery peak systolic velocity (MCA‐PSV) for the prediction of late selective intrauterine growth restriction (sIUGR) at birth and birth weight discrepancy of > 25% (BW‐25) in otherwise uncomplicated monochorionic–diamniotic (MCDA) twin pregnancies.

OC09.04: Crown–rump length and abdominal circumference discrepancy as early predictors of late adverse pregnancy outcome in monochorionic diamniotic pregnancies

the last 10 years. Chorionicity and indication for invasive testing were retrieved from the clinical notes. The following outcomes were analysed: fetal loss within 4 weeks from the procedure and < 24 weeks’ gestation; preterm premature rupture of membranes (PPROM) within 4 weeks from the procedure and < 34 weeks’ gestation; spontaneous preterm delivery (PTD) < 32 weeks of gestation. Results: A total of 267 twin pregnancies underwent invasive prenatal diagnosis during the study period, 212 dichorionic diamniotic and 55 monochorionic diamniotic. Amniocentesis was the most frequent procedure in both groups. Indications for invasive testing, type of procedure used, and pregnancy outcomes are described in Table 1 and reported with their 95% confidence intervals. Conclusions: We observed a fetal loss rate < 24 weeks of 1.5% (95% CI, 0.3–4.3). As expected, monochorionic pregnancies had a higher incidence of adverse pregnancy outcome.

OC09.02: Complications and outcome of invasive prenatal diagnosis in twin pregnancies

Objectives: In first trimester risk assessment, crown–rump length has been utilized as the gold standard for dating pregnancies and interpreting screening results. Other fetal biometric measurements have been employed to confirm gestational age, but not to interpret screening results. The purpose of this study is the compare the accuracy and precision of crown–rump length and other fetal biometric measurements in the interpretation of first trimester nuchal translucency. The goal is to determine which measurement leads to the least variability when an observed nuchal translucency measurement is related to the expected level for the observed biometry value (MoMs). Methods: Women presenting to an academic fetal diagnostic center between 11+0 and 13+6 weeks were examined by one sonographer followed by one physician. Each examiner obtained 3 independent measurements of fetal biometric parameters, and NT. Patients were excluded for fetal malformations or demise. Biometry-specific expected NT values were calculated using regression models, and the results were converted into MoMs. The standard deviation of log MoM was compared, and the smallest value was regarded as reflecting the biometric measure with the greatest accuracy and precision. Results: Measurements were obtained on 135 fetuses. Abdominal circumference yielded MoMs with the smallest standard deviation, significantly lower than for CRL, the next smallest (P < 0.0001). The standard deviation of AC remained the smallest when results from sonographers and physicians were considered separately, and when the mean of the three exams was used rather than the individual exam results. Conclusions: Abdominal circumference is the most accurate and precise biometric measurement for the interpretation of nuchal translucency screening results. Since crown rump length is currently utilized to calculate NT MoMs in order to place fetuses in categories of risk for aneuploidy, consideration should be given to an alternative model for calculation of NT MoMs using other fetal biometric measurements. OC09: COMPLICATIONS OF TWIN PREGNANCY