Definition establish in Delphi procedure |
|
---|---|
DC twins | MC twins |
EFW <3rd centile or | |
EFW of one foetus <10th centile | EFW of one foetus <10th centile |
AC is not taken into account | AC of one foetus <10th centile |
The disproportion between foetal weight ≥25% | The disproportion between foetal weight ≥25% |
UAPI of smaller foetus >95th centile | UAPI of smaller foetus >95th centile |
2/3 have to be present to recognise sFGR | 2/4 have to be present to recognise sFGR |
sFGR twins | Color Doppler | Foetal growth assessment |
---|---|---|
DC | Biweekly or more frequent | Biweekly |
MC | Once a week or more frequent |
Society | Date of publication | Definition of sFGR | Growth charts | Other twins recommendation |
---|---|---|---|---|
NICE | 2019 | ≥25% EFW discordance and EFW of one foetus <10th centile for GA | Undefined | |
ACOG | 2019 | One foetus has EFW <10th centile and disproportion between EFW >20% | Undefined | |
ISOUG | 2016 | One foetus has EFW <10th centile and the intertwin weight discordance >25% | Singleton | |
RAN-ZOG | 2017 | Undefined | Undefined | Recommendation about MC twins but without definitions of FGR |
SOGC | 2017 | AC and/or EFW of one or both twins are <10th centile or when growth discordance is identified | Singleton | |
ACR | 2017 | One foetus EFW <10th centile and the intertwin EFW discordance >25% | Singleton | |
FIGO | 2019 | One foetus EFW <10th centile and the intertwin EFW discordance >25% | Twin | |
Delphi consensus | 2019 | Separates MC and DC twins, EFW <3rd centile |
Singleton |
sFGR Type | ||||
---|---|---|---|---|
Chorionicity | I | II | III | IV |
UAPI >95th centile |
AEDF | REDF, DV PI >95th centile | DV a wave reversed | |
UAPI >95th | AREDF | iAREDF | DV a wave reversed (it is not stage IV in MC) | |
Recommended GA at delivery (weeks) | ||||
34–36 | 30–32 | 30–32 | >26 This is the UK-recommended treatment. In Poland, it is not legally possible to terminate a pregnancy or perform selective termination after the end of 22 weeks. |
|
34–36 | 30–32 | 30–32 | >26 |
|
37 | 34 | 30 | 26 |
Perinatal outcome | DC | MC |
---|---|---|
Second twin IUD | 3% | 15% |
Preterm labour before 32 weeks | 54% | 68% |
Abnormalities in CNS imaging of survivor | 16% | 34% |
Neurodevelopment retardation of survivor | 2% | 26% |