IMR Press / CEOG / Volume 45 / Issue 1 / DOI: 10.12891/ceog3740.2018

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 46 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research
Placental pathology findings and birth weight discordance
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1 School of Health Sciences, Central Michigan University, Mount Pleasant, MI, USA
2 Division of Maternal Fetal Medicine, BC Women's Hospital, Vancouver, Canada
Clin. Exp. Obstet. Gynecol. 2018, 45(1), 30–38; https://doi.org/10.12891/ceog3740.2018
Published: 10 February 2018
Abstract

Purpose: To assess the fetal, perinatal, and maternal outcomes in twin pregnancy according to chorionicity. Materials and Methods: This was a retrospective cohort study of 1,571 twin pregnancies with placental pathological examination collected from 2000-2010. Fetal, neonatal, and maternal outcomes of twins were compared via multivariate analysis. Results: Placenta anastomosis, unequal placenta sharing, cord size, and cord insertion type were found to be the key elements that impacted growth discordance in twin gestations. Higher rates of severe growth discordance were negatively associated with higher frequencies of anastomosis. Placentas in monochorionic twins were more likely to have shared arteries/veins. Discussion: Monochorionic placentas compensate for lack of nutritional flow by penetrating to other placenta surfaces. Compensation for lack of vascular sufficiency would mean a fused placenta or sharing more portions of the placenta. Higher rates of unequal placenta sharing among growth discordant twins is reported irrespective of chorionicity. Conclusion: Attention to placenta pathology is important in growth discordant twins.
Keywords
Twin
Placenta
Chorionicity
Growth discordance
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