The impact of placental anastomoses and umbilical cord insertions' sites on monochorionic twin pregnancy outcomes: Evidence from color-dye injection studies

被引：2

作者：

Bonanni, Giulia ^{[1
]}

Airoldi, Chiara ^{[2
]}

Romanzi, Federica ^{[1
]}

Passananti, Elvira ^{[3
]}

Torcia, Eleonora ^{[1
]}

Di Marco, Giulia ^{[1
]}

Felici, Francesca ^{[1
]}

Familiari, Alessandra ^{[1
,3
]}

Meli, Federica ^{[1
]}

Visconti, Daniela ^{[1
,3
]}

Lanzone, Antonio ^{[1
,3
]}

Bevilacqua, Elisa ^{[1
,3
,4
]}

机构：

[1] Univ Cattolica Sacro Cuore, Unit Obstet & Gynecol, Rome, Italy

[2] Univ Piemonte Orientale, Dept Translat Med, Novara, Italy

[3] Fdn Policlin Univ Agostino Gemelli IRCCS, Dept Women & Child Hlth, Women Hlth Area, Rome, Italy

[4] IRCCS A Gemelli Univ Polyclin Fdn, Dept Womens & Child Hlth Sci & Publ Hlth, Largo Agostino Gemelli 8, I-00168 Rome, Italy

来源：

PLACENTA | 2023年 / 143卷

关键词：

Twin pregnancy; Monochorionicity; Cord insertions; Velamentous cord insertion; Placental anastomoses; VASCULAR ANASTOMOSES; DIAMNIOTIC TWINS; PROSPECTIVE RISK; COMPLICATIONS; CHORIONICITY; MANAGEMENT; GROWTH;

D O I：

10.1016/j.placenta.2023.10.007

中图分类号：

Q [生物科学];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Introduction: Our knowledge of monochorionic pregnancies' complications is largely based on the extensive ongoing research on monochorionic placental structure. Previous studies on the concordance of umbilical cord insertions are limited. This study aimed to evaluate placental anastomoses and cord insertions as independent risk factors for neonatal adverse outcomes.Methods: This was a prospective study conducted at Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy from April 2021 to December 2022. Seventy-six women with a monochorionic pregnancy were enrolled at their first-trimester scan. After delivery, all placentas that were confirmed to be monochorionic were analyzed according to standard protocols, including those of complicated monochorionic twin pregnancies. The primary outcomes were a Composite Monochorionic Pregnancy Outcome (CMPO) and a Composite Neonatal Adverse Outcome (CNAO). The secondary outcome was the birth weight discordance between the neonates.Results: The CMPO occurred in 15.8 % pregnancies, and the CNAO occurred in 67.1 % pregnancies. The analysis confirmed a significant association between velamentous cord insertions and neonatal adverse events (p = 0.003). Also, a significant positive association (p = 0.0326) between twin birth weight discordance and discordance in twins umbilical cord insertions' sites was found. No significant association between the number and type of the anastomoses and both the CMPO or CNAO was detected.Discussion: Our data suggest that the routine sonographic assessment of umbilical cords' insertion sites during the first trimester could be helpful in predicting fetal and neonatal adverse events. We believe that this sonographic assessment should start to be implemented in our routine care of monochorionic pregnancies.

引用

页码：110 / 116

页数：7