Ultrasound CRL Differences Key in Predicting sIUGR in MCDA Twins

In a recent study published in BMC Pregnancy and Childbirth, researchers delved into the significance of ultrasound indicators in early pregnancy for predicting selective intrauterine growth restriction (sIUGR) and twin–twin transfusion syndrome (TTTS) in Monochorionic diamniotic (MCDA) twin pregnancies. These complications are common and necessitate timely diagnosis and intervention to enhance perinatal outcomes.

The research, conducted as a retrospective study at the Obstetrics Department of Shandong Provincial Hospital Affiliated to Shandong University, spanned from January 2017 to March 2024. The study included MCDA twin cases categorized into sIUGR, TTTS, TTTS with sIUGR, and normal MCDA groups. Ultrasound measurements of embryo length, crown-rump lengths (CRL), and nuchal translucency (NT) during the 7–14 week gestation period were recorded for each group.

Analysis of 722 MCDA twins revealed that the CRL difference was significantly greater in the sIUGR group compared to the control group. However, no significant differences were found in NT or embryo length. The CRL difference was effective in predicting sIUGR but not TTTS. The study showed that a CRL difference threshold of 7.38% predicted sIUGR with 80.72% sensitivity and 67% specificity.

MCDA twin pregnancies pose challenges due to the risk of sIUGR and TTTS. Early detection and management are crucial for improving outcomes. While CRL differences can aid in predicting sIUGR, they may not be as effective for TTTS. The study highlights the importance of leveraging ultrasound indicators for early identification of complications in MCDA twins.

The study also sheds light on the varying outcomes associated with sIUGR based on the type, emphasizing the need for tailored management strategies. Additionally, the research underscores the significance of accurate diagnosis and intervention in MCDA twin pregnancies to mitigate adverse perinatal outcomes.

Despite the promising findings regarding CRL differences in predicting sIUGR, further research is warranted to validate these results and explore the utility of other ultrasound indicators in anticipating sIUGR and TTTS in MCDA twins. The study’s limitations, such as its retrospective nature and single-centre data collection, highlight the need for larger-scale studies to confirm these findings and enhance the generalizability of the results.