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Project

The Twin Growth Project - Pathophysiology, diagnosis and outcomes of isolated selective fetal growth restriction in monochorionic twin pregnancies

Monochorionic twins are monozygotic and during their intrauterine
life, they share a single placenta with anastomoses connecting their
circulations. Although identical, in about one in five pairs, one twin is
significantly smaller than the other. The best management of
selective intrauterine growth restriction (sIUGR) is unknown and still
poses daily clinical dilemmas, especially when the blood flow towards
the smaller twin is disturbed and birth is not an option yet. In these
pregnancies, the growth-restricted fetus may die, which puts the
normally growing co-twin at risk of demise or ischemic brain damage
due to exsanguination across the anastomoses. Also, we do not fully
understand its pathophysiology, and current diagnostic criteria are
insufficient. Our research proposal consists of the multi-center
retrospective "ALIGN" study, which analyzes management-related
outcomes of severe sIUGR in the pre-viable period to inform a
patient decision aid and an aligned management protocol. Second,
the multi-center prospective 'TWIN GROWTH" study aims to identify
additional prenatal diagnostic markers to distinguish between sIUGR
pregnancies with expected good outcomes and those at high risk of
fetal demise or requiring an extreme preterm birth. Finally, in the
"TWIN CAKE" study, we focus on the histologic differences between
the different types of sIUGR to increase our knowledge of the
underlying pathophysiology.

Date:1 Oct 2022 →  Today
Keywords:monochorionic twin, prenatal ultrasound, placenta
Disciplines:Foetal development