The Prediction Of The Differences In CRL,Umbilical Artery Blood Flow S/D Ratio And AFV For Discordant Growth In Dichorionic Twin

Objective Accurately determining growth inconsistency in dichorionic twins has always been a significant challenge in clinical practice.This study explored the relationship between the differences in crown-rump length(CRL),umbilical artery maximum end systolic blood flow velocity/maximum end diastolic blood flow velocity ratio(S/D),and amniotic fluid volume(AFV)and growth inconsistency in dichorionic twins.The main objective of this study is to determine whether detecting these differences during pregnancy can provide new insights for the clinical diagnosis of growth discordance in dichorionic twins.Methods According to the inclusion and exclusion criteria,a total of 485 cases women with dichorionic diamniotic twin pregnancies who received outpatient follow-up and inpatient delivery at the Jiaxing Maternal and Child Health Hospital from January 2021 to December 2022 were collected.There were 485 pairs newborns delivered in total.The birth weight difference between the twin pairs was calculated using the following formula:(weight of the heavier twin-weight of the lighter twin)/weight of the heavier twin × 100%.Dichorionic diamniotic twin pregnancies with a birth weight difference≥20%were diagnosed as discordant growth.The 485 twin pairs were divided into a discordant group of 74 twin pairs and a concordant group of 411 twin pairs based on the birth weight difference.An ultrasound report of the twins within the corresponding gestational age was randomly selected for both groups,then the CRL difference,umbilical artery blood flow S/D ratio difference,and AFV difference of the two groups were recorded and observed.Meanwhile,according to the birth weight difference,umbilical artery blood flow S/D ratio difference and amniotic fluid volume difference were observed in the discordant group.Results 1.The study revealed notable difference in gestational weeks and delivery times of the parturient between the discordant and concordant groups,whereas age,delivery mode,and number of pregnancies exhibited no significant differences.2.In the early stages of pregnancy,there was no marked variation in the CRL difference between the discordant and concordant groups.3.However,there was no significant variance in the umbilical artery flow S/D ratio difference between the discordant and concordant groups during the corresponding gestational age.4.Conversely,a statistically significant difference in the AFV difference between the discordant and concordant groups was evident when gestational week s were greater than 32 weeks.5.Additionally,the umbilical artery flow S/D ratio and AFV differences showed no significant differences concerning the birth weight disparity in the discordant group.Conclusions 1.The growth discordance observed in dichorionic diamniotic twin pregnancies appears to be influenced by delivery times of the parturient and gestational weeks of the current pregnancy.The concordant group,on the other hand,may have a longer gestational period.2.However,the CRL difference in early pregnancy may not be a reliable indicator for distinguishing discordant growth in such pregnancies.3.Moreover,the difference in umbilical artery flow S/D ratio at different stages of middle and late pregnancy cannot predict discordant growth in dichorionic diamniotic twin pregnancies.4.While the AFV difference in twin pregnancies between 20 and 32 gestational weeks may not predict discordant growth,there appears to be a relationship between AFV difference and discordant growth when gestational weeks exceed 32 weeks.Notably,the discordant group may exhibit larger AFV differences.5.The degree of difference in the umbilical artery flow S/D ratio and AFV may not have significant predictive value for the progression of the birth weight disparity in the discordant group.