1247 The Doppler Velocimetry in Twin Pregnancy Complicated by Intrauterine Growth Restriction is Predictive of Neonatal Outcome?

Abstract

Objective: to assess whether Doppler velocimetry is predictive of neonatal outcome in bichorionic and monochorionic twin pregnancies complicated by intrauterine growth restriction.

Methods: were collected retrospectively data of all twin pregnancies complicated by intrauterine growth restriction during the period between January 2006 and December 2009.

Intrauterine Growth Restricted fetuses (IUGR) were defined as fetuses with estimated fetal weight (EFW) < 10^th percentile with abnormal Doppler velocimetry (umbilical artery PI > 2 SD) and Small for Gestational Age (SGA) fetuses with EFW< 10^th percentile and normal Doppler velocimetry. SGA infants were defined birth weight below the 10th percentile according to reference curves for gestational age. Were registered recovery in NICU and neonatal outcomes.

Results: among 349 infants considered, the incidence of selective intrauterine growth restriction with alteration of Doppler velocimetry was found to be 5.7%, while of SGA of 20.3%. The condition of IUGR was associated with an inferior birth weight (median 1241, IQR 785-1700 p< 0.0001) and gestational age at delivery (median 31 gestational age, IQR 30-33 p< 0.0001). The Apgar at 5′ is also lower than the non IUGR group (8 vs 9, range 8-9 p = 0.03). There was no statistically significant differences between IUGR and non IUGR group; moreover there wasn't a significant different outcome between IUGR and SGA neonates.

Conclusions: alterations in Doppler velocimetry allow to identify a group of fetuses with intrauterine growth restriction at risk. In terms of neonatal outcome there are no significant differences of morbidity and mortality between IUGR and no IUGR.

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